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Towards highly accelerated Cartesian time-resolved 3D flow cardiovascular magnetic resonance in the clinical setting.

Giese D, Wong J, Greil GF, Buehrer M, Schaeffter T, Kozerke S - J Cardiovasc Magn Reson (2014)

Bottom Line: Accelerated time-resolved 3D flow data were successfully acquired in all subjects with 8-fold nominal scan acceleration.Highly accelerated time-resolved 3D flow using k-t PCA is readily applicable in clinical routine protocols of CHD patients.Nominal scan times of 6 min are well tolerated and allow for quantitative and qualitative flow assessment in all great vessels.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK. daniel.giese@uk-koeln.de.

ABSTRACT

Background: The clinical applicability of time-resolved 3D flow cardiovascular magnetic resonance (CMR) remains compromised by the long scan times associated with phase-contrast imaging. The present work demonstrates the applicability of 8-fold acceleration of Cartesian time-resolved 3D flow CMR in 10 volunteers and in 9 patients with different congenital heart diseases (CHD). It is demonstrated that accelerated 3D flow CMR data acquisition and image reconstruction using k-t PCA (principal component analysis) can be implemented into clinical workflow and results are sufficiently accurate relative to conventional 2D flow CMR to permit for comprehensive flow quantification in CHD patients.

Methods: The fidelity of k-t PCA was first investigated on retrospectively undersampled data for different acceleration factors and compared to k-t SENSE and fully sampled reference data. Subsequently, k-t PCA with 8-fold nominal undersampling was applied on 10 healthy volunteers and 9 CHD patients on a clinical 1.5 T MR scanner. Quantitative flow validation was performed in vessels of interest on the 3D flow datasets and compared to 2D through-plane flow acquisitions. Particle trace analysis was used to qualitatively visualise flow patterns in patients.

Results: Accelerated time-resolved 3D flow data were successfully acquired in all subjects with 8-fold nominal scan acceleration. Nominal scan times excluding navigator efficiency were on the order of 6 min and 7 min in patients and volunteers. Mean differences in stroke volume in selected vessels of interest were 2.5 ± 8.4 ml and 1.63 ± 4.8 ml in volunteers and patients, respectively. Qualitative flow pattern analysis in the time-resolved 3D dataset revealed valuable insights into hemodynamics including circular and helical patterns as well as flow distributions and origin in the Fontan circulation.

Conclusion: Highly accelerated time-resolved 3D flow using k-t PCA is readily applicable in clinical routine protocols of CHD patients. Nominal scan times of 6 min are well tolerated and allow for quantitative and qualitative flow assessment in all great vessels.

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Bland-Altman stroke volume analysis. Bland-Altman plot comparing stroke volumes extracted from 2D flow and highly accelerated 3D flow data in volunteers (left) and patients (right).
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Figure 2: Bland-Altman stroke volume analysis. Bland-Altman plot comparing stroke volumes extracted from 2D flow and highly accelerated 3D flow data in volunteers (left) and patients (right).

Mentions: A correlation and Bland-Altman analysis of all stroke volumes derived from 2D flow acquisitions and undersampled 3D flow data reconstructed using k-t PCA are shown in Figure 2. Linear regression resulted in a correlation coefficient of R2 = 0.93 and the Bland-Altman analysis revealed an underestimation of stroke volume by 2.5 ± 8.4 ml with 3D flow corresponding to 5.6 ± 14.9% with respect to the stroke volumes derived from the 2D flow datasets. Peak flow rates from the 3D datasets showed an underestimation by 5.1 ± 7.5% with respect to the 2D datasets.


Towards highly accelerated Cartesian time-resolved 3D flow cardiovascular magnetic resonance in the clinical setting.

Giese D, Wong J, Greil GF, Buehrer M, Schaeffter T, Kozerke S - J Cardiovasc Magn Reson (2014)

Bland-Altman stroke volume analysis. Bland-Altman plot comparing stroke volumes extracted from 2D flow and highly accelerated 3D flow data in volunteers (left) and patients (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230248&req=5

Figure 2: Bland-Altman stroke volume analysis. Bland-Altman plot comparing stroke volumes extracted from 2D flow and highly accelerated 3D flow data in volunteers (left) and patients (right).
Mentions: A correlation and Bland-Altman analysis of all stroke volumes derived from 2D flow acquisitions and undersampled 3D flow data reconstructed using k-t PCA are shown in Figure 2. Linear regression resulted in a correlation coefficient of R2 = 0.93 and the Bland-Altman analysis revealed an underestimation of stroke volume by 2.5 ± 8.4 ml with 3D flow corresponding to 5.6 ± 14.9% with respect to the stroke volumes derived from the 2D flow datasets. Peak flow rates from the 3D datasets showed an underestimation by 5.1 ± 7.5% with respect to the 2D datasets.

Bottom Line: Accelerated time-resolved 3D flow data were successfully acquired in all subjects with 8-fold nominal scan acceleration.Highly accelerated time-resolved 3D flow using k-t PCA is readily applicable in clinical routine protocols of CHD patients.Nominal scan times of 6 min are well tolerated and allow for quantitative and qualitative flow assessment in all great vessels.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK. daniel.giese@uk-koeln.de.

ABSTRACT

Background: The clinical applicability of time-resolved 3D flow cardiovascular magnetic resonance (CMR) remains compromised by the long scan times associated with phase-contrast imaging. The present work demonstrates the applicability of 8-fold acceleration of Cartesian time-resolved 3D flow CMR in 10 volunteers and in 9 patients with different congenital heart diseases (CHD). It is demonstrated that accelerated 3D flow CMR data acquisition and image reconstruction using k-t PCA (principal component analysis) can be implemented into clinical workflow and results are sufficiently accurate relative to conventional 2D flow CMR to permit for comprehensive flow quantification in CHD patients.

Methods: The fidelity of k-t PCA was first investigated on retrospectively undersampled data for different acceleration factors and compared to k-t SENSE and fully sampled reference data. Subsequently, k-t PCA with 8-fold nominal undersampling was applied on 10 healthy volunteers and 9 CHD patients on a clinical 1.5 T MR scanner. Quantitative flow validation was performed in vessels of interest on the 3D flow datasets and compared to 2D through-plane flow acquisitions. Particle trace analysis was used to qualitatively visualise flow patterns in patients.

Results: Accelerated time-resolved 3D flow data were successfully acquired in all subjects with 8-fold nominal scan acceleration. Nominal scan times excluding navigator efficiency were on the order of 6 min and 7 min in patients and volunteers. Mean differences in stroke volume in selected vessels of interest were 2.5 ± 8.4 ml and 1.63 ± 4.8 ml in volunteers and patients, respectively. Qualitative flow pattern analysis in the time-resolved 3D dataset revealed valuable insights into hemodynamics including circular and helical patterns as well as flow distributions and origin in the Fontan circulation.

Conclusion: Highly accelerated time-resolved 3D flow using k-t PCA is readily applicable in clinical routine protocols of CHD patients. Nominal scan times of 6 min are well tolerated and allow for quantitative and qualitative flow assessment in all great vessels.

Show MeSH
Related in: MedlinePlus