Validation of 2D flow MRI for helical and vortical flows
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ..
PURPOSE: The main objective of this study was to develop two-dimensional (2D) phase contrast (PC) methods to quantify the helicity and vorticity of blood flow in the aortic root.
METHODS: This proof-of-concept study used four-dimensional (4D) flow cardiovascular MR (4D flow CMR) data of five healthy controls, five patients with heart failure with preserved ejection fraction and five patients with aortic stenosis (AS). A PC through-plane generated by 4D flow data was treated as a 2D PC plane and compared with the original 4D flow. Visual assessment of flow vectors was used to assess helicity and vorticity. We quantified flow displacement (FD), systolic flow reversal ratio (sFRR) and rotational angle (RA) using 2D PC.
RESULTS: For visual vortex flow presence near the inner curvature of the ascending aortic root on 4D flow CMR, sFRR demonstrated an area under the curve (AUC) of 0.955, p<0.001. A threshold of >8% for sFRR had a sensitivity of 82% and specificity of 100% for visual vortex presence. In addition, the average late systolic FD, a marker of flow eccentricity, also demonstrated an AUC of 0.909, p<0.001 for visual vortex flow. Manual systolic rotational flow angle change (ΔsRA) demonstrated excellent association with semiautomated ΔsRA (r=0.99, 95% CI 0.9907 to 0.999, p<0.001). In reproducibility testing, average systolic FD (FDsavg) showed a minimal bias at 1.28% with a high intraclass correlation coefficient (ICC=0.92). Similarly, sFRR had a minimal bias of 1.14% with an ICC of 0.96. ΔsRA demonstrated an acceptable bias of 5.72°-and an ICC of 0.99.
CONCLUSION: 2D PC flow imaging can possibly quantify blood flow helicity (ΔRA) and vorticity (FRR). These imaging biomarkers of flow helicity and vorticity demonstrate high reproducibility for clinical adoption.
TRIALS REGISTRATION NUMBER: NCT05114785.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Open heart - 11(2024), 1 vom: 08. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mehmood, Zia [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic Diseases |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 19.03.2024 published: Electronic ClinicalTrials.gov: NCT05114785 Citation Status MEDLINE |
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| doi: |
10.1136/openhrt-2023-002451 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369485068 |
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| 245 | 1 | 0 | |a Validation of 2D flow MRI for helical and vortical flows |
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| 500 | |a Date Completed 11.03.2024 | ||
| 500 | |a Date Revised 19.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT05114785 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. | ||
| 520 | |a PURPOSE: The main objective of this study was to develop two-dimensional (2D) phase contrast (PC) methods to quantify the helicity and vorticity of blood flow in the aortic root | ||
| 520 | |a METHODS: This proof-of-concept study used four-dimensional (4D) flow cardiovascular MR (4D flow CMR) data of five healthy controls, five patients with heart failure with preserved ejection fraction and five patients with aortic stenosis (AS). A PC through-plane generated by 4D flow data was treated as a 2D PC plane and compared with the original 4D flow. Visual assessment of flow vectors was used to assess helicity and vorticity. We quantified flow displacement (FD), systolic flow reversal ratio (sFRR) and rotational angle (RA) using 2D PC | ||
| 520 | |a RESULTS: For visual vortex flow presence near the inner curvature of the ascending aortic root on 4D flow CMR, sFRR demonstrated an area under the curve (AUC) of 0.955, p<0.001. A threshold of >8% for sFRR had a sensitivity of 82% and specificity of 100% for visual vortex presence. In addition, the average late systolic FD, a marker of flow eccentricity, also demonstrated an AUC of 0.909, p<0.001 for visual vortex flow. Manual systolic rotational flow angle change (ΔsRA) demonstrated excellent association with semiautomated ΔsRA (r=0.99, 95% CI 0.9907 to 0.999, p<0.001). In reproducibility testing, average systolic FD (FDsavg) showed a minimal bias at 1.28% with a high intraclass correlation coefficient (ICC=0.92). Similarly, sFRR had a minimal bias of 1.14% with an ICC of 0.96. ΔsRA demonstrated an acceptable bias of 5.72°-and an ICC of 0.99 | ||
| 520 | |a CONCLUSION: 2D PC flow imaging can possibly quantify blood flow helicity (ΔRA) and vorticity (FRR). These imaging biomarkers of flow helicity and vorticity demonstrate high reproducibility for clinical adoption | ||
| 520 | |a TRIALS REGISTRATION NUMBER: NCT05114785 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic Diseases | |
| 650 | 4 | |a Aortic Valve Stenosis | |
| 650 | 4 | |a Heart Failure | |
| 650 | 4 | |a Magnetic Resonance Imaging | |
| 700 | 1 | |a Assadi, Hosamadin |e verfasserin |4 aut | |
| 700 | 1 | |a Grafton-Clarke, Ciaran |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Matthews, Gareth |e verfasserin |4 aut | |
| 700 | 1 | |a Alabed, Samer |e verfasserin |4 aut | |
| 700 | 1 | |a Girling, Rebekah |e verfasserin |4 aut | |
| 700 | 1 | |a Underwood, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Kasmai, Bahman |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Xiaodan |e verfasserin |4 aut | |
| 700 | 1 | |a Ricci, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Zhong, Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Aung, Nay |e verfasserin |4 aut | |
| 700 | 1 | |a Petersen, Steffen Erhard |e verfasserin |4 aut | |
| 700 | 1 | |a Swift, Andrew J |e verfasserin |4 aut | |
| 700 | 1 | |a Vassiliou, Vassilios S |e verfasserin |4 aut | |
| 700 | 1 | |a Cavalcante, João |e verfasserin |4 aut | |
| 700 | 1 | |a Geest, Rob J van der |e verfasserin |4 aut | |
| 700 | 1 | |a Garg, Pankaj |e verfasserin |4 aut | |
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