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Inlet and outlet valve flow and regurgitant volume may be directly and reliably quantified with accelerated, volumetric phase-contrast MRI.

ABSTRACT: To determine whether it is feasible to use solely an accelerated 4D phase-contrast magnetic resonance imaging (4D-PC MRI) acquisition to quantify net and regurgitant flow volume through each of the cardiac valves.Accelerated, 4D-PC MRI examinations performed between March 2010 through June 2011 as part of routine MRI examinations for congenital, structural heart disease were retrospectively reviewed and analyzed using valve-tracking visualization and quantification algorithms developed in Java and OpenGL. Excluding patients with transposition or single ventricle physiology, a total of 34 consecutive pediatric patients (19 male, 15 female; mean age 6.9 years; age range 10 months to 15 years) were identified. 4D-PC flow measurements were compared at each valve and against routine measurements from conventional cardiac MRI using Bland-Altman and Pearson correlation analysis.Inlet and outlet valve net flow were highly correlated between all valves (P?=?0.940-0.985). The sum of forward flow at the outlet valve and regurgitant flow at the inlet valve were consistent with volumetric displacements in each ventricle (P?=?0.939-0.948). These were also highly consistent with conventional planar MRI measurements with net flow (P?=?0.923-0.935) and regurgitant fractions (P?=?0.917-0.972) at the outlet valve and ventricular volumes (P?=?0.925-0.965).It is possible to obtain consistent measurements of net and regurgitant blood flow across the inlet and outlet valves relying solely on accelerated 4D-PC. This may facilitate more efficient clinical quantification of valvular regurgitation.

SUBMITTER: Hsiao A

PROVIDER: S-EPMC4126899 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Inlet and outlet valve flow and regurgitant volume may be directly and reliably quantified with accelerated, volumetric phase-contrast MRI.

Hsiao Albert A Tariq Umar U Alley Marcus T MT Lustig Michael M Vasanawala Shreyas S SS

Journal of magnetic resonance imaging : JMRI 20140208 2

<h4>Purpose</h4>To determine whether it is feasible to use solely an accelerated 4D phase-contrast magnetic resonance imaging (4D-PC MRI) acquisition to quantify net and regurgitant flow volume through each of the cardiac valves.<h4>Materials and methods</h4>Accelerated, 4D-PC MRI examinations performed between March 2010 through June 2011 as part of routine MRI examinations for congenital, structural heart disease were retrospectively reviewed and analyzed using valve-tracking visualization and ...[more]

PMID: 24677253

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Project description:BACKGROUND:Rapid volumetric imaging protocols could better utilize limited scanner resources. PURPOSE:To develop and validate an optimized 6-minute high-resolution volumetric brain MRI examination using Wave-CAIPI encoding. STUDY TYPE:Prospective. POPULATION/SUBJECTS:Ten healthy subjects and 20 patients with a variety of intracranial pathologies. FIELD STRENGTH/SEQUENCE:At 3?T, MPRAGE, T2 -weighted SPACE, SPACE FLAIR, and SWI were acquired at 9-fold acceleration using Wave-CAIPI and for comparison at 2-4-fold acceleration using conventional GRAPPA. ASSESSMENT:Extensive simulations were performed to optimize the Wave-CAIPI protocol and minimize both g-factor noise amplification and potential T1 /T2 blurring artifacts. Moreover, refinements in the autocalibrated reconstruction of Wave-CAIPI were developed to ensure high-quality reconstructions in the presence of gradient imperfections. In a randomized and blinded fashion, three neuroradiologists assessed the diagnostic quality of the optimized 6-minute Wave-CAIPI exam and compared it to the roughly 3× slower GRAPPA accelerated protocol using both an individual and head-to-head analysis. STATISTICAL TEST:A noninferiority test was used to test whether the diagnostic quality of Wave-CAIPI was noninferior to the GRAPPA acquisition, with a 15% noninferiority margin. RESULTS:Among all sequences, Wave-CAIPI achieved negligible g-factor noise amplification (gavg ???1.04) and burring artifacts from T1 /T2 relaxation. Improvements of our autocalibration approach for gradient imperfections enabled increased robustness to gradient mixing imperfections in tilted-field of view (FOV) prescriptions as well as variations in gradient and analog-to-digital converter (ADC) sampling rates. In the clinical evaluation, Wave-CAIPI achieved similar mean scores when compared with GRAPPA (MPRAGE: ØW ?=?4.03, ØG ?=?3.97; T2 w SPACE: ØW ?=?4.00, ØG ?=?4.00; SPACE FLAIR: ØW ?= 3.97, ØG ?=?3.97; SWI: ØW ?=?3.93, ØG ?=?3.83) and was statistically noninferior (N?=?30, P?<?0.05 for all sequences). DATA CONCLUSION:The proposed volumetric brain exam retained comparable image quality when compared with the much longer conventional protocol. LEVEL OF EVIDENCE:2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:961-974.

Dataset Information

Inlet and outlet valve flow and regurgitant volume may be directly and reliably quantified with accelerated, volumetric phase-contrast MRI.

Publications

Inlet and outlet valve flow and regurgitant volume may be directly and reliably quantified with accelerated, volumetric phase-contrast MRI.

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