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Published on: February 25, 2022
Assessment of altered three-dimensional blood characteristics in aortic disease by velocity distribution analysis
Julio Garcia1, Alex J Barker1, Pim van Ooij1
1Department of Radiology, Northwestern University, Chicago, USA.
Insights
Velocity distribution analysis using 4D flow MRI can identify altered blood flow patterns in patients with aortic disease. This method reveals distinct hemodynamic changes associated with disease progression, aiding in diagnosis.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Hemodynamics
Background:
- Aortic disease encompasses conditions like aortic dilation and stenosis, significantly impacting cardiovascular health.
- Accurate assessment of blood flow dynamics is crucial for diagnosing and managing aortic pathologies.
- Traditional imaging methods may not fully capture the complex three-dimensional (3D) flow alterations in the aorta.
Purpose of the Study:
- To evaluate the feasibility of using 3D velocity distribution analysis derived from 4D flow MRI.
- To identify characteristic changes in 3D flow patterns associated with various stages of aortic disease.
Main Methods:
- Cardiovascular MRI was performed on 40 patients with varying degrees of aortic dilation and aortic stenosis.
- Four-dimensional (4D) flow MRI data were acquired and processed to generate 3D velocity vector fields.
- The aorta was segmented into four regions (root, ascending, arch, descending), and radial charts visualized segmental velocity distribution.
Main Results:
- Distinct hemodynamic patterns were observed across different aortic segments, correlating with disease severity.
- Significant differences in flow parameters (P < 0.05) were found between patient cohorts.
- Disease progression led to substantial increases in radial chart size for the aortic root (146%) and ascending aorta (99%).
Conclusions:
- Volumetric 4D flow MRI velocity distribution analysis is a feasible method for characterizing aortic disease.
- This technique can identify specific regional blood flow alterations indicative of aortic pathologies.
- The findings suggest potential for improved diagnostic capabilities in patients with aortic conditions.
Purpose:
To test the feasibility of velocity distribution analysis for identifying altered three-dimensional (3D) flow characteristics in patients with aortic disease based on 4D flow MRI volumetric analysis.
Methods:
Forty patients with aortic (Ao) dilation (mid ascending aortic diameter MAA = 40 ± 7 mm, age = 56 ± 17 years, 11 females) underwent cardiovascular MRI. Four groups were retrospectively defined: mild Ao dilation (n = 10; MAA < 35 mm); moderate Ao dilation (n = 10; 35 < MAA < 45 mm); severe Ao dilation (n = 10; MAA > 45 mm); Ao dilation+aortic stenosis AS (n = 10; MAA > 35 mm and peak velocity > 2.5 m/s). The 3D PC-MR angiograms were computed and used to obtain a 3D segmentation of the aorta which was divided into four segments: root, ascending aorta, arch, descending aorta. Radial chart displays were used to visualize multiple parameters representing segmental changes in the 3D velocity distribution associated with aortic disease.
Results:
Changes in the velocity field and geometry between cohorts resulted in distinct hemodynamic patterns for each aortic segment. Disease progression from mild to Ao dilation + AS resulted in significant differences (P < 0.05) in flow parameters across cohorts and increased radial chart size for root and ascending aorta segments by 146% and 99%, respectively.
Conclusion:
Volumetric 4D velocity distribution analysis has the potential to identify characteristic changes in regional blood flow patterns in patients with aortic disease.
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