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Voxel-by-voxel 4D flow MRI-based assessment of regional reverse flow in the aorta.


ABSTRACT: BACKGROUND:Complex and reverse flow in the aorta has been implicated in aneurysm development and stroke via retrograde embolization. PURPOSE:To evaluate global and regional differences between standard 2D plane-based and volumetric voxel-based quantification of regional forward/reverse flow, and reverse flow fraction (RFF) in the aorta. STUDY TYPE:Retrospective. SUBJECTS:In all, 35 subjects: 10 healthy controls (age: 57?±?7 years, nine male), nine patients without aortic valve regurgitation (AR) (age: 63?±?10 years, seven male), six patients with mild AR (age: 66?±?6 years, five male), and 10 with moderate or severe AR (age: 60?±?16 years, eight male). FIELD STRENGTH/SEQUENCE:4D flow MRI (3T and 1.5T) was employed to acquire 3D blood flow velocities with entire thoracic aorta in all subjects. ASSESSMENT:Data analysis included standard 2D plane-based quantification of forward/reverse flow, and RFF-plane. In addition, a new semiautomatic workflow based on 3D segmentation and extraction of an aorta centerline was developed for voxel-by-voxel visualization (forward/reverse flow and RFF-voxel maps) and quantification of regional voxel-by-voxel forward/reverse flow in the entire thoracic aorta. STATISTICAL TESTS:Kruskal-Wallis tests were performed to test for differences between groups. A two-sample t-test or Wilcoxon rank sum test was used to compare voxel-based and plane-based results. RESULTS:Semiautomatic plane-based analysis showed excellent agreement with standard manual plane-based analysis for net flow and RFF-plane (RFF-plane: y?=?0.99x-0.0, net flow: y?=?1.00x-0.21, R > 0.99, P < 0.0001). Voxel-by-voxel maps demonstrated marked regional flow reversal in the ascending aorta in all patients and RFF-voxel was significantly increased (P < 0.001) compared to RFF-plane for all four groups, with the most pronounced differences for mild AR (18.0?±?15.2% vs. 4.7?±?5.4%). Voxel-based flow and RFF-voxel along the aorta showed areas with marked regional flow reversal (eg, vortex flow) compared to plane-based analysis. DATA CONCLUSION:Voxel-based analysis demonstrated regional flow reversal that was not detected by plane-based analysis. LEVEL OF EVIDENCE:3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1276-1286.

SUBMITTER: Shen X 

PROVIDER: S-EPMC5857433 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Voxel-by-voxel 4D flow MRI-based assessment of regional reverse flow in the aorta.

Shen Xin X   Schnell Susanne S   Barker Alex J AJ   Suwa Kenichiro K   Tashakkor Lingzi L   Jarvis Kelly K   Carr James C JC   Collins Jeremy D JD   Prabhakaran Shyam S   Markl Michael M  

Journal of magnetic resonance imaging : JMRI 20170918 5


<h4>Background</h4>Complex and reverse flow in the aorta has been implicated in aneurysm development and stroke via retrograde embolization.<h4>Purpose</h4>To evaluate global and regional differences between standard 2D plane-based and volumetric voxel-based quantification of regional forward/reverse flow, and reverse flow fraction (RFF) in the aorta.<h4>Study type</h4>Retrospective.<h4>Subjects</h4>In all, 35 subjects: 10 healthy controls (age: 57 ± 7 years, nine male), nine patients without ao  ...[more]

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