Respiratory-resolved five-dimensional flow cardiovascular magnetic resonance : In-vivo validation and respiratory-dependent flow changes in healthy volunteers and patients with congenital heart disease.

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Elizabeth K Weiss, Justin Baraboo, Cynthia K Rigsby, Joshua D Robinson, Liliana Ma, Mariana B L Falcão, Christopher W Roy, Matthias Stuber, Michael Markl
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Abstract

Background: This study aimed to validate respiratory-resolved five-dimensional (5D) flow cardiovascular magnetic resonance (CMR) against real-time two-dimensional (2D) phase-contrast MRI, assess the impact of number of respiratory states, and measure the impact of respiration on hemodynamics in congenital heart disease (CHD) patients.

Methods: Respiratory-resolved 5D flow MRI-derived net and peak flow measurements were compared to real-time 2D phase-contrast MRI-derived measurements in 10 healthy volunteers. Pulmonary-to-systemic flow ratios (Qp:Qs) were measured in 19 CHD patients and aortopulmonary collateral burden was measured in 5 Fontan patients. Additionally, the impact of number of respiratory states on measured respiratory-driven net flow changes was investigated in 10 healthy volunteers and 19 CHD patients (shunt physiology, n = 11, single ventricle disease [SVD], n = 8).

Results: There was good agreement between 5D flow MRI and real-time 2D phase-contrast-derived net and peak flow. Respiratory-driven changes had a good correlation (rho = 0.64, p < 0.001). In healthy volunteers, fewer than four respiratory states reduced measured respiratory-driven flow changes in veins (5.2 mL/cycle, p < 0.001) and arteries (1.7 mL/cycle, p = 0.05). Respiration drove substantial venous net flow changes in SVD (64% change) and shunt patients (57% change). Respiration had significantly greater impact in SVD patients compared to shunt patients in the right and left pulmonary arteries (46% vs 15%, p = 0.003 and 59% vs 20%, p = 0.002). Qp:Qs varied by 37 ± 24% over respiration in SVD patients and 12 ± 20% in shunt patients. Aortopulmonary collateral burden varied by 118 ± 84% over respiration in Fontan patients. The smallest collateral burden was measured during active inspiration in all patients and the greatest burden was during active expiration in four of five patients. Reduced respiratory resolution blunted measured flow changes in the caval veins of shunt and SVD patients (p < 0.005).

Conclusions: Respiratory-resolved 5D flow MRI measurements agree with real-time 2D phase contrast. Venous measurements are sensitive to number of respiratory states, whereas arterial measurements are more robust. Respiration has a substantial impact on caval vein flow, Qp:Qs, and collateral burden in CHD patients.

呼吸分辨 5D 血流 MRI:健康志愿者和先天性心脏病患者的体内验证和呼吸相关血流变化。
背景:本研究旨在验证呼吸分辨 5D 血流 MRI 与实时 2D 相位对比 MRI 的比较,评估呼吸状态数量的影响,并测量呼吸对先天性心脏病(CHD)患者血液动力学的影响:方法:在 10 名健康志愿者中,将呼吸分辨 5D 流量 MRI 得出的净流量和峰值流量测量值与实时 2D 相位对比 MRI 得出的测量值进行比较。在 19 名先天性心脏病患者中测量了肺血流与全身血流的比率(Qp:Qs),在 5 名丰坦患者中测量了主动脉-肺侧支负担。此外,还研究了 10 名健康志愿者和 19 名 CHD 患者(分流生理,11 人;单心室疾病(SVD),8 人)的呼吸状态数量对测量的呼吸驱动净血流变化的影响:结果:5D血流磁共振成像与实时二维相位对比得出的净血流和峰值血流之间有很好的一致性。呼吸驱动的变化具有良好的相关性(rho=0.64,p结论:呼吸分辨 5D 血流 MRI 测量结果与实时 2D 相位对比结果一致。静脉测量对呼吸状态的数量很敏感,而动脉测量则更稳健。呼吸对冠心病患者的腔静脉血流、Qp:Qs 和侧支负担有很大影响。
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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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