Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment

Springer Science and Business Media LLC - Tập 6 Số 1
Hosamadin Assadi1, Bhalraam Uthayachandran2, Rui Li1, James Wardley1, Tha H. Nyi3, Ciaran Grafton-Clarke3, Andrew J. Swift4, Ana Beatriz Solana5, Jean‐Paul Aben6, Kurian Thampi3, David Hewson3, Chris Sawh3, Richard Greenwood3, Marina Hughes3, Bahman Kasmai3, Liang Zhong7, Marcus Flather3, Vassilios Vassiliou3, Pankaj Garg3
1University of East Anglia, Norwich Medical School, Norfolk, UK
2Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK
3Norfolk and Norwich University Hospitals NHS Foundation Trust, Norfolk, UK
4Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School and Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
5ASL Europe, GE Healthcare, Munich, Germany
6Pie Medical Imaging BV, Maastricht, The Netherlands
7National Heart Centre Singapore, 5 Hospital Drive, Singapore, Singapore

Tóm tắt

Abstract Background To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow. Methods This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients. Results The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001). Conclusions Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.

Từ khóa


Tài liệu tham khảo

Paddock S, Tsampasian V, Assadi H et al (2021) Clinical translation of three-dimensional scar, diffusion tensor imaging, four-dimensional flow, and quantitative perfusion in cardiac MRI: a comprehensive review. Front Cardiovasc Med. 8:682027. https://doi.org/10.3389/fcvm.2021.682027.

Juffermans JF, Minderhoud SCS, Wittgren J et al (2021) Multicenter consistency assessment of valvular flow quantification with automated valve tracking in 4D flow CMR. JACC Cardiovasc Imaging. 14:1354–1366. https://doi.org/10.1016/j.jcmg.2020.12.014.

Mills MT, Grafton-Clarke C, Williams G et al (2021) Feasibility and validation of trans-valvular flow derived by four-dimensional flow cardiovascular magnetic resonance imaging in patients with atrial fibrillation. Wellcome Open Res. 6:73. https://doi.org/10.12688/wellcomeopenres.16655.2.

Fidock B, Archer G, Barker N et al (2021) Standard and emerging CMR methods for mitral regurgitation quantification. Int J Cardiol. 331:316–321. https://doi.org/10.1016/j.ijcard.2021.01.066.

Chowdhary A, Garg P, Das A, Nazir MS, Plein S (2021) Cardiovascular magnetic resonance imaging: emerging techniques and applications. Heart. 107:697–704. https://doi.org/10.1136/heartjnl-2019-315669.

Saunderson CED, Paton MF, Chowdhary A et al (2020) Feasibility and validation of trans-valvular flow derived by four-dimensional flow cardiovascular magnetic resonance imaging in pacemaker recipients. Magn Reson Imaging. 74:46–55. https://doi.org/10.1016/j.mri.2020.08.024.

Fidock B, Barker N, Balasubramanian N et al (2019) A systematic review of 4D-flow MRI derived mitral regurgitation quantification methods. Front Cardiovasc Med. 6:103. https://doi.org/10.3389/fcvm.2019.00103.

Zhong L, Schrauben EM, Garcia J et al (2019) Intracardiac 4D flow MRI in congenital heart disease: recommendations on behalf of the ISMRM Flow & Motion Study Group. J Magn Reson Imaging. 50:677–681. https://doi.org/10.1002/jmri.26858.

Garg P, van der Geest RJ, Swoboda PP et al (2019) Left ventricular thrombus formation in myocardial infarction is associated with altered left ventricular blood flow energetics. Eur Heart J Cardiovasc Imaging 20:108–117. https://doi.org/10.1093/ehjci/jey121.

Garg P, Swift AJ, Zhong L et al (2020) Assessment of mitral valve regurgitation by cardiovascular magnetic resonance imaging. Nat Rev Cardiol. 17:298–312. https://doi.org/10.1038/s41569-019-0305-z

Assadi H, Grafton-Clarke C, Demirkiran A et al (2022) Mitral regurgitation quantified by CMR 4D-flow is associated with microvascular obstruction post reperfused ST-segment elevation myocardial infarction. BMC Res Notes. 15:181. https://doi.org/10.1186/s13104-022-06063-7.

Grafton-Clarke C, Njoku P, Aben J-P et al (2022) Validation of aortic valve pressure gradient quantification using semi-automated 4D flow CMR pipeline. BMC Res Notes. 15:151. https://doi.org/10.1186/s13104-022-06033-z.

Njoku P, Wardley J, Garg P (2022) Streamline-based three-dimensional peak-velocity tracing of transvalvular flow using four-dimensional flow cardiac magnetic resonance imaging for left ventricular diastolic assessment in aortic regurgitation: a case report. J Med Case Rep 16:205. https://doi.org/10.1186/s13256-022-03422-7.

Wardley J, Swift A, Ryding A, Garg P (2021) Four-dimensional flow cardiovascular magnetic resonance for the assessment of mitral stenosis. Eur Heart J Case Rep. 5:ytab465. https://doi.org/10.1093/ehjcr/ytab465

Zhao X, Hu L, Leng S et al (2022) Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 24:4. https://doi.org/10.1186/s12968-021-00832-2.

Zhao X, Tan R-S, Garg P et al (2021) Impact of age, sex and ethnicity on intra-cardiac flow components and left ventricular kinetic energy derived from 4D flow CMR. Int J Cardiol. 336:105–112. https://doi.org/10.1016/j.ijcard.2021.05.035.

Kaur H, Assadi H, Alabed S et al (2020) Left Ventricular Blood Flow Kinetic Energy Assessment by 4D Flow Cardiovascular Magnetic Resonance: A Systematic Review of the Clinical Relevance. J Cardiovasc Dev Dis. 7(3):37. https://doi.org/10.3390/jcdd7030037

Garg P, Westenberg JJM, van den Boogaard PJ et al (2017) Comparison of fast acquisition strategies in whole-heart four-dimensional flow cardiac MR: Two-center, 1.5 Tesla, phantom and in vivo validation study. J Magn Reson Imaging. 47:272–281. https://doi.org/10.1002/jmri.25746.

Zhang J-M, Tan RS, Zhang S et al (2018) Comparison of Image Acquisition Techniques in Four-Dimensional Flow Cardiovascular MR on 3 Tesla in Volunteers and Tetralogy of Fallot Patients. Annu Int Conf IEEE Eng Med Biol Soc. 2018:1115–1118. https://doi.org/10.1109/EMBC.2018.8512412.

Hsiao A, Tariq U, Alley MT, Lustig M, Vasanawala SS (2015) Inlet and outlet valve flow and regurgitant volume may be directly and reliably quantified with accelerated, volumetric phase-contrast MRI. J Magn Reson Imaging. 41:376–385. https://doi.org/10.1002/jmri.24578.

Hanneman K, Sivagnanam M, Nguyen ET et al (2014) Magnetic resonance assessment of pulmonary (QP) to systemic (QS) flows using 4D phase-contrast imaging: pilot study comparison with standard through-plane 2D phase-contrast imaging. Acad Radiol. 21:1002–1008. https://doi.org/10.1016/j.acra.2014.04.012.

Kanski M, Töger J, Steding-Ehrenborg K et al (2015) Whole-heart four-dimensional flow can be acquired with preserved quality without respiratory gating, facilitating clinical use: a head-to-head comparison. BMC Med Imaging 15:20. https://doi.org/10.1186/s12880-015-0061-4.

Petersson S, Sigfridsson A, Dyverfeldt P, Carlhäll C-J, Ebbers T (2016) Retrospectively gated intracardiac 4D flow MRI using spiral trajectories. Magn Reson Med. 75:196–206. https://doi.org/10.1002/mrm.25612.

Isorni MA, Martins D, Ben Moussa N et al (2020) 4D flow MRI versus conventional 2D for measuring pulmonary flow after Tetralogy of Fallot repair. Int J Cardiol. 300:132–136. https://doi.org/10.1016/j.ijcard.2019.10.030.

Horowitz MJ, Kupsky DF, El-Said HG, Alshawabkeh L, Kligerman SJ, Hsiao A (2021) 4D flow MRI quantification of congenital shunts: comparison to invasive catheterization. Radiol Cardiothorac Imaging. 3:e200446. https://doi.org/10.1016/10.1148/ryct.2021200446.

Chelu RG, Horowitz M, Sucha D et al (2019) Evaluation of atrial septal defects with 4D flow MRI—multilevel and inter-reader reproducibility for quantification of shunt severity. MAGMA. 32:269–279. https://doi.org/10.1016/10.1007/s10334-018-0702-z.

Lai P, Shimakawa A, Cheng JY, Alley MT, Vasanawala S, Brau AC (2015) Sub-8-minute cardiac four dimensional flow MRI using kat ARC and variable density signal averaging. J Cardiovasc Magn Reson. 17:Q36

Robinson S, Rana B, Oxborough D et al (2020) A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset. Echo Res Pract. 7:G59–G93. https://doi.org/10.1530/ERP-20-0026.

Hälvä R, Vaara SM, Peltonen JI et al (2021) Peak flow measurements in patients with severe aortic stenosis: a prospective comparative study between cardiovascular magnetic resonance 2D and 4D flow and transthoracic echocardiography. J Cardiovasc Magn Reson. 23:132. https://doi.org/10.1186/s12968-021-00825-1.

Archer GT, Elhawaz A, Barker N et al (2020) Validation of four-dimensional flow cardiovascular magnetic resonance for aortic stenosis assessment. Sci Rep. 10:10569. https://doi.org/10.1038/s41598-020-66659-6

Bane O, Peti S, Wagner M et al (2019) Hemodynamic measurements with an abdominal 4D flow MRI sequence with spiral sampling and compressed sensing in patients with chronic liver disease. J Magn Reson Imaging. 49:994–1005. https://doi.org/10.1002/jmri.26305.

Stankovic Z (2016) Four-dimensional flow magnetic resonance imaging in cirrhosis. World J Gastroenterol 22:89–102. https://doi.org/10.3748/wjg.v22.i1.89.

Motosugi U, Roldán-Alzate A, Bannas P et al (2019) Four-dimensional flow MRI as a marker for risk stratification of gastroesophageal varices in patients with liver cirrhosis. Radiology. 290:101–107. https://doi.org/10.1148/radiol.2018180230.

Rutkowski DR, Reeder SB, Fernandez LA, Roldán-Alzate A (2018) Surgical planning for living donor liver transplant using 4D flow MRI, computational fluid dynamics and in vitro experiments. Comput Methods Biomech Biomed Eng Imaging Vis. 6:545–555. https://doi.org/10.1080/21681163.2017.1278619.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 6 Số 1

Thông tin tác giả