Retrospectively gated intracardiac 4D flow MRI using spiral trajectories

To develop and evaluate retrospectively gated spiral readout four-dimensional (4D) flow MRI for intracardiac flow analysis.

Retrospectively gated spiral 4D flow MRI was implemented on a 1.5-tesla scanner. The spiral sequence was compared against conventional Cartesian 4D flow (SENSE [sensitivity encoding] 2) in seven healthy volunteers and three patients (only spiral). In addition to comparing flow values, linear regression was used to assess internal consistency of aortic versus pulmonary net volume flows and left ventricular inflow versus outflow using quantitative pathlines analysis.

Total scan time with spiral 4D flow was 44% ± 6% of the Cartesian counterpart (13 ± 3 vs. 31 ± 7 min). Aortic versus pulmonary flow correlated strongly for the spiral sequence (P < 0.05, slope = 1.03, R(2) = 0.88, N = 10), whereas the linear relationship for the Cartesian sequence was not significant (P = 0.06, N = 7). Pathlines analysis indicated good data quality for the spiral (P < 0.05, slope = 1.02, R(2) = 0.90, N = 10) and Cartesian sequence (P < 0.05, slope = 1.10, R(2) = 0.93, N = 7). Spiral and Cartesian peak flow rate (P < 0.05, slope = 0.96, R(2) = 0.72, N = 14), peak velocity (P < 0.05, slope = 1.00, R(2) = 0.81, N = 14), and pathlines flow components (P < 0.05, slope = 1.04, R(2) = 0.87, N = 28) correlated well.

Retrospectively gated spiral 4D flow MRI permits more than two-fold reduction in scan time compared to conventional Cartesian 4D flow MRI, while maintaining similar data quality.