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Visualizing and quantifying flow stasis in abdominal aortic aneurysms in men using 4D flow MRI.

Magnus Ziegler1, Martin Welander2, Jonas Lantz1

  • 1Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.

Magnetic Resonance Imaging
|November 17, 2018
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Summary

Particle travel distance analysis (TDA) and mean velocity analysis (MVA) are effective for quantifying flow stasis in abdominal aortic aneurysms (AAA) using 4D Flow MRI, outperforming conventional volumetric residence time (VRT) calculations.

Keywords:
4D flow MRIAbdominal aortic aneurysmFlow stasisHemodynamics

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Area of Science:

  • Cardiovascular Imaging
  • Medical Physics
  • Fluid Dynamics

Background:

  • Abdominal aortic aneurysms (AAA) pose significant risks, with flow stasis being a key factor in their progression.
  • Accurate visualization and quantification of flow stasis are crucial for understanding AAA pathophysiology and patient risk stratification.
  • 4D Flow Magnetic Resonance Imaging (MRI) offers advanced capabilities for assessing complex hemodynamics within AAA.

Purpose of the Study:

  • To evaluate and compare three distinct methods for quantifying flow stasis in AAA using 4D Flow MRI.
  • To assess the sensitivity of different quantification methods to common 4D Flow MRI artifacts, such as noise and background phase-offset errors.
  • To determine which method provides the most reliable and visually consistent quantification of flow stasis compared to conventional flow visualization techniques.

Main Methods:

  • Numerical simulations were used to generate ideal 4D Flow MRI data, serving as a benchmark for evaluating quantification methods under simulated artifact conditions.
  • Three methods were investigated: conventional volumetric residence time (VRT), mean velocity analysis (MVA), and particle travel distance analysis (TDA).
  • 4D Flow MRI data from 13 patients with AAA were acquired and analyzed to compare the performance of VRT, MVA, and TDA against established flow visualization techniques.

Main Results:

  • Particle travel distance analysis (TDA) and mean velocity analysis (MVA) demonstrated superior robustness against noise and background phase-offset errors compared to volumetric residence time (VRT).
  • TDA exhibited R² values of 0.99 for noise and 0.96 for phase-offset errors, significantly outperforming VRT (R²=0.69 and R²=0.14, respectively).
  • Qualitative assessment showed TDA achieved better agreement with conventional flow visualizations than MVA, indicating its higher reliability in representing actual flow patterns.

Conclusions:

  • 4D Flow MRI can reliably quantify flow stasis in abdominal aortic aneurysms (AAA).
  • Methods like MVA and TDA are less susceptible to measurement errors inherent in 4D Flow MRI compared to VRT.
  • TDA is recommended for its accuracy and strong agreement with conventional flow visualization, offering a more dependable approach to assessing AAA hemodynamics.