JOURNAL ARTICLE

Quantification of thoracic blood flow using volumetric magnetic resonance imaging with radial velocity encoding: in vivo validation

Alex Frydrychowicz, Oliver Wieben, Eric Niespodzany, Scott B Reeder, Kevin M Johnson, Christopher J François
Investigative Radiology 2013, 48 (12): 819-25
23857136

OBJECTIVES: The objective of this study was to validate radially undersampled 5-point velocity-encoded time-resolved flow-sensitive magnetic resonance imaging (MRI) ("PC-VIPR", phase contrast vastly undersampled imaging with isotropic resolution projection reconstruction magnetic resonance) for the quantification of ascending aortic (AAO) and main pulmonary artery (MPA) flow in vivo.

MATERIALS AND METHODS: Data from 18 healthy volunteers (41.6 ± 16.2 years [range, 22-73 years]; body mass index, 26.0 ± 3.5 [19.1-31.4]) scanned at 3 T with a 32-channel coil were included. The left and right ventricular stroke volumes calculated from contiguous short-axis CINE-balanced steady state free precession (CINE-bSSFP) slices were used as the primary reference for cardiac output. Flow measured from 2-dimensional phase contrast MRI (2D-PC-MRI) in the AAO and the MPA served as the secondary reference. Time-resolved 4-dimensional flow-sensitive MRI (4D flow MRI) using PC-VIPR was performed with a velocity sensitivity of Venc = 150 cm/s reconstructed to 20 time frames at 1.4-mm isotropic spatial resolution. In 11 of 20 volunteers, phantom-corrected 4D flow MRI data were also assessed. Differences between methods of calculating the left ventricular and right ventricular cardiac output were assessed with the Bland-Altman analysis (BA, mean difference ±2SD). The QP/QS-ratio was calculated for each method.

RESULTS: Initially, PC-VIPR compared unfavorably with CINE-bSSFP (left ventricular stroke volume: 96.5 ± 14.4 mL; right ventricular stroke volume: 93.6 ± 14.0 mL vs 81.2 ± 24.3 mL [AAO] and 85.6 ± 25.4 mL [MPA]; P = 0.027 and 0.25) with BA differences of -14.6 ± 44.0 mL (AAO) and -9.0 ± 45.9 mL (MPA). Whereas phantom correction had minor effects on 2D-PC-MRI results and comparison with CINE-bSSFP, it improved PC-VIPR results: BA differences between CINE-bSSFP and PC-VIPR after correction were -1.4 ± 15.3 mL (AAO) and -4.1 ± 16.1 mL (MPA); BA comparison with 2D-PC-MRI improved to -12.0 ± 48.1 mL (AAO) and -2.2 ± 19.5 mL (MPA). QP/QS-ratio results for all techniques were within physiologic limits.

CONCLUSIONS: Accurate quantification of AAO and MPA flows with radially undersampled 4D flow MRI applying 5-point velocity encoding is achievable when phantom correction is used.

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