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4D Flow Imaging in Aortic Disease

  • Zhen Qian
  • Xiao Zhou
  • Mani Vannan
Chapter

Abstract

The flow hemodynamics in the aorta plays a critical role in the formation and development of aortic disease. 4D flow imaging using phase-contrast magnetic resonance (4D PC-MRI) has been developed and performed in both research and clinical care to study the blood flow in the heart and the great vessels. Compared to 2D flow imaging, 4D PC-MRI allows retrospective visualization and quantification of the time-varying 3D blood flow pattern in the 3D volume of the aorta, and provides more comprehensive visual and quantitative tools to study the complex relationship between flow hemodynamics and aortic pathophysiology in the development of aortic disease. In this chapter, we will describe the image acquisition technique, the image pre-processing method, the data visualization technique, and the quantitative hemodynamic markers of the 4D flow PC-MRI in the aorta. This chapter will also give an overview of the potential clinical applications of the flow visualization and the flow quantifications derived from 4D flow imaging for aortic disease.

References

  1. 1.
    Richter Y, Edelman ER. Cardiology is flow. Circulation. 2006;113(23):2679–82.CrossRefPubMedGoogle Scholar
  2. 2.
    Cheng C, Tempel D, van Haperen R, et al. Atherosclerotic lesion size and vulnerability are determined by patterns of fluid shear stress. Circulation. 2006;113(23):2744–53.CrossRefPubMedGoogle Scholar
  3. 3.
    Stankovic Z, Allen BD, Garcia J, Jarvis KB, Markl M. 4D flow imaging with MRI. Cardiovasc Diagn Ther. 2014;4(2):173–92.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Eriksson J, Bolger AF, Ebbers T, Carlhäll C-J. Four-dimensional blood flow-specific markers of LV dysfunction in dilated cardiomyopathy. Eur Heart J Cardiovasc Imaging. 2012;14(5):417–24.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Dyverfeldt P, Bissell M, Barker AJ, et al. 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson. 2015;17:72.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Hess AT, Bissell MM, Ntusi NAB, et al. Aortic 4D flow: quantification of signal-to-noise ratio as a function of field strength and contrast enhancement for 1.5T, 3T, and 7T. Magn Reson Med. 2015;73(5):1864–71.CrossRefPubMedGoogle Scholar
  7. 7.
    Walker PG, Cranney GB, Scheidegger MB, Waseleski G, Pohost GM, Yoganathan AP. Semiautomated method for noise reduction and background phase error correction in MR phase velocity data. J Magn Reson Imaging. 1993;3(3):521–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Sengupta PP, Pedrizzetti G, Kilner PJ, et al. Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012;5(3):305–16.CrossRefPubMedGoogle Scholar
  9. 9.
    Clough RE, Waltham M, Giese D, Taylor PR, Schaeffter T. A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 2012;55(4):914–23.CrossRefPubMedGoogle Scholar
  10. 10.
    Markl M, Wallis W, Harloff A. Reproducibility of flow and wall shear stress analysis using flow-sensitive four-dimensional MRI. J Magn Reson Imaging. 2011;33(4):988–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Bissell MM, Hess AT, Biasiolli L, et al. Aortic dilation in bicuspid aortic valve disease: flow pattern is a major contributor and differs with valve fusion type. Circ Cardiovasc Imaging. 2013;6(4):499–507.CrossRefPubMedGoogle Scholar
  12. 12.
    Westenberg JJM, Scholte AJHA, Vaskova Z, et al. Age-related and regional changes of aortic stiffness in the Marfan syndrome: assessment with velocity-encoded MRI. J Magn Reson Imaging. 2011;34(3):526–31.CrossRefPubMedGoogle Scholar
  13. 13.
    Allen BD, Barker AJ, Carr JC, Silverberg RA, Markl M. Time-resolved three-dimensional phase contrast MRI evaluation of bicuspid aortic valve and coarctation of the aorta. Eur Heart J Cardiovasc Imaging. 2013;14(4):399.CrossRefPubMedGoogle Scholar
  14. 14.
    Frydrychowicz A, Markl M, Hirtler D, et al. Aortic hemodynamics in patients with and without repair of aortic coarctation: in vivo analysis by 4D flow-sensitive magnetic resonance imaging. Investig Radiol. 2011;46(5):317–25.Google Scholar
  15. 15.
    Dyverfeldt P, Hope MD, Tseng EE, Saloner D. Magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis. JACC Cardiovasc Imaging. 2013;6(1):64–71.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Barker AJ, van Ooij P, Bandi K, et al. Viscous energy loss in the presence of abnormal aortic flow. Magn Reson Med. 2014;72(3):620–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Yang GZ, Kilner PJ, Wood NB, Underwood SR, Firmin DN. Computation of flow pressure fields from magnetic resonance velocity mapping. Magn Reson Med. 1996;36(4):520–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Sigovan M, Hope MD, Dyverfeldt P, Saloner D. Comparison of four-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta. J Magn Reson Imaging. 2011;34(5):1226–30.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardiovascular ImagingPiedmont Heart InstituteAtlantaUSA
  2. 2.Department of CardiologyChinese PLA General HospitalBeijingChina

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