Radiology. Cardiothoracic imaging最新文献

{"title":"Cardiovascular MRI Feature-Tracking Strain Rate for Assessment of Diastolic Function.","authors":"Jian L Yeo, Abhishek Dattani, Aseel Alfuhied, Anna-Marie Marsh, Kelly S Parke, Sarah L Ayton, Lavanya Athithan, Joanna M Bilak, Alastair J Moss, Emer M Brady, J Ranjit Arnold, Prathap Kanagala, Christopher D Steadman, Matthew P M Graham-Brown, Melanie J Davies, Anvesha Singh, Iain B Squire, Leong L Ng, Gaurav S Gulsin, Gerry P McCann","doi":"10.1148/ryct.240447","DOIUrl":"https://doi.org/10.1148/ryct.240447","url":null,"abstract":"<p><p>Purpose To compare left ventricular (LV) peak early diastolic strain rate (PEDSR) and peak late diastolic strain rate (PLDSR) using cardiac MRI feature tracking (FT) across a spectrum of diastolic dysfunction and determine the association between diastolic strain rates and cardiac remodeling. Materials and Methods Between October 2008 and December 2022, cardiac MRI and echocardiography were performed in prospectively recruited cohorts with type 2 diabetes mellitus, heart failure with preserved ejection fraction, and severe aortic stenosis, as well as asymptomatic participants without diabetes. Diastolic dysfunction was classified using established echocardiography guidelines. Global circumferential and longitudinal PEDSR and PLDSR were measured at cardiac MRI. Linear regression was performed to identify independent associations between LV diastolic strain rates and remodeling. Results A total of 600 participants (mean age, 65.2 years ± 8.4 [SD]; 361 of 600 male participants [60%]) were included. Proportions of participants with normal diastolic function and those with grade 1, indeterminate, and grade 2 or 3 diastolic dysfunction were 92 of 600 (15%), 401 of 600 (67%), 85 of 600 (14%), and 22 of 600 (4%), respectively. Compared with participants who had normal function, PEDSR decreased in those with grade 1 dysfunction (circumferential PEDSR, 0.99 sec^-1 ± 0.22 vs 0.81 sec^-1 ± 0.24 [<i>P</i> < .001]; longitudinal PEDSR, 0.79 sec^-1 ± 0.19 vs 0.60 sec^-1 ± 0.19 [<i>P</i> < .001]) and remained low throughout worsening stages of diastolic dysfunction. In contrast, compared with participants who had normal diastolic function, PLDSR increased in those with grade 1 dysfunction (circumferential PLDSR, 0.70 sec^-1 ± 0.17 vs 0.82 sec^-1 ± 0.23 [<i>P</i> < .001]; longitudinal PLDSR, 0.73 sec^-1 ± 0.18 vs 0.80 sec^-1 ± 0.27 [<i>P</i> < .001]) and declined progressively with worsening diastolic dysfunction. After multivariable adjustment for risk factors, inverse associations persisted between PEDSR and PLDSR with cardiac remodeling. Conclusion A distinctive pattern of cardiac MRI FT early and late diastolic strain rates was observed across the range of diastolic dysfunction. <b>Keywords:</b> Diastolic Dysfunction, Peak Early Diastolic Strain Rate, Peak Late Diastolic Strain Rate, Feature Tracking <i>Supplemental material is available for this article.</i> © The Author(s) 2025. Published by the Radiological Society of North America under a CC BY 4.0 license.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 5","pages":"e240447"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Xenon 129 Ventilation MRI in Cystic Fibrosis with Spiral Imaging and Flip-Angle Correction.","authors":"Riaz Hussain, Joseph W Plummer, Abdullah S Bdaiwi, Matthew M Willmering, Elizabeth L Kramer, Laura L Walkup, Zackary I Cleveland","doi":"10.1148/ryct.240574","DOIUrl":"https://doi.org/10.1148/ryct.240574","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Purpose To implement and evaluate two-dimensional spiral hyperpolarized xenon 129 (&lt;sup&gt;129&lt;/sup&gt;Xe) ventilation MRI with flip-angle (FA) correction, as compared with conventional N4ITK (N4) correction, in healthy individuals and those with cystic fibrosis (CF). Materials and Methods In this prospective study, participants with mild CF and age-matched healthy control participants underwent &lt;sup&gt;129&lt;/sup&gt;Xe ventilation MRI using both rapid spiral (approximately 3 seconds) and conventional Cartesian (approximately 10 seconds) acquisitions. Images were corrected using N4 bias correction, and ventilation defect percentage (VDP) was calculated using median-anchored generalized linear binning (mGLB). Separately, B&lt;sub&gt;1&lt;/sub&gt; inhomogeneities in spiral images were FA-corrected and analyzed using mGLB. Gravitational gradients in ventilation were quantified from uncorrected and N4- and FA-corrected images in healthy participants. VDP from N4-corrected (VDP&lt;sub&gt;N4&lt;/sub&gt;) and FA-corrected (VDP&lt;sub&gt;FA&lt;/sub&gt;) images were compared between participant groups and against reader-segmented VDP (VDP&lt;sub&gt;RS&lt;/sub&gt;). Statistical analyses included Wilcoxon signed rank test, Pearson correlation, and Bland-Altman analysis. Results The final analysis included 38 participants with CF (mean age, 16 years ± 6 [SD]; 20 female) and 25 healthy controls (mean age, 18 years ± 7; 13 male). Qualitatively, Cartesian and spiral acquisitions produced similar regional ventilation images. There was no evidence of a difference in VDP&lt;sub&gt;N4&lt;/sub&gt; between acquisition types (Cartesian = 9.1% ± 8.1; spiral = 9.3% ± 8.7; &lt;i&gt;P&lt;/i&gt; = .97) with strong correlation (&lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.95; &lt;i&gt;P&lt;/i&gt; &lt; .001) and no systemic bias (mean difference, -0.2%; 95% CI: 3.6, -3.9). FA correction removed coil-related inhomogeneities while preserving physiologic heterogeneity, including gravitational gradients that were removed by N4 correction (mean slope in healthy participants: FA-corrected = 0.026 &lt;i&gt;S&lt;/i&gt;&lt;sub&gt;Norm&lt;/sub&gt;/cm ± 0.013; N4-corrected = 0.002 &lt;i&gt;S&lt;/i&gt;&lt;sub&gt;Norm&lt;/sub&gt;/cm ± 0.001; &lt;i&gt;P&lt;/i&gt; &lt; .001). VDP&lt;sub&gt;N4&lt;/sub&gt; and VDP&lt;sub&gt;FA&lt;/sub&gt; were strongly correlated with VDP&lt;sub&gt;RS&lt;/sub&gt; (&lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.94 and 0.95, respectively; &lt;i&gt;P&lt;/i&gt; &lt; .001 for both). Defect masks from FA-corrected images showed better agreement with reader segmentations compared with N4-corrected image-based defect masks (17% higher Dice score from FA-corrected images; mean Dice score: N4-corrected, 0.41 ± 0.31; FA-corrected, 0.48 ± 0.29; &lt;i&gt;P&lt;/i&gt; =.001) and better depicted regional hypo- and hyperventilation. Conclusion Two-dimensional spiral acquisition combined with FA correction and mGLB analysis enabled rapid &lt;sup&gt;129&lt;/sup&gt;Xe ventilation MRI, effectively mitigating inhomogeneities while preserving physiologic heterogeneity. This approach provided accurate and efficient quantification of ventilation abnormalities in both healthy individuals and individuals with CF. &lt;b&gt;Keywords:&lt;/b&gt; MRI, Pulmonary, Lung, Xe","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 5","pages":"e240574"},"PeriodicalIF":4.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Assist Devices: Advances, Complications, and Pitfalls.","authors":"Robert Ambrosini, Keva Green, Katherine Kaproth-Joslin, Jeffrey Alexis, Bryan Barrus, Igor Gosev, Abhishek Chaturvedi, Susan K Hobbs","doi":"10.1148/ryct.240218","DOIUrl":"https://doi.org/10.1148/ryct.240218","url":null,"abstract":"<p><p>Left ventricular assist devices (LVADs) are used for short-term support, as a bridge to transplant, or as destination therapy in patients with end-stage systolic heart failure. Imaging plays a crucial role in assessing the anatomic suitability for implantation and in detecting complications following both implantation and explantation. LVAD-associated complications can affect the pump, inflow cannula, outflow graft, or driveline. Echocardiography is effective for evaluating inflow cannula position and certain parameters, such as inflow and outflow velocities, valvular regurgitation, and ventricular dilatation; however, its ability to visualize the interiors of the inflow and outflow cannulas is limited. MRI is contraindicated for patients with LVADs. Contrast-enhanced chest CT imaging has become the preferred diagnostic modality for evaluating outflow graft complications. This imaging essay describes the CT findings and complications associated with LVADs, particularly the commercially available HeartMate II and HeartMate 3 devices (Abbott Laboratories). The HeartWare device (Medtronic), although recalled by the U.S. Food and Drug Administration, will also be mentioned. <b>Keywords:</b> Cardiac Assist Devices, CT Imaging <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240218"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac CT for Aortic Stenosis: Novel Quantitative Techniques for Comprehensive Patient Assessment.","authors":"Davide Margonato, Miho Fukui, Takahiro Nishihara, Paul Sorajja, Vinayak Bapat, Maurice Enriquez-Sarano, João L Cavalcante","doi":"10.1148/ryct.240572","DOIUrl":"10.1148/ryct.240572","url":null,"abstract":"<p><p>In recent years, the landscape for the diagnosis and management of patients with aortic stenosis (AS) has rapidly changed, with a dramatic increase in therapeutic options and substantial advances in different imaging modalities. Multidetector CT (MDCT) has become an essential imaging tool for evaluating the feasibility of both surgical and interventional treatments for patients with severe AS. Novel MDCT imaging acquisition protocols, postprocessing tools, and technological advances offer not only detailed anatomic information for adequate procedural planning but also comprehensive quantitative evaluation of the myocardium for assessment of remodeling and function, both of which have prognostic and therapeutic implications. This review provides a comprehensive update on the role of novel MDCT quantitative techniques in the assessment of patients with severe AS. <b>Keywords:</b> CT, Cardiac, Valves, Aortic Stenosis © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240572"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperpolarized ¹²⁹Xe MRI and Spectroscopy: Quantitative Measurements, Results, and Emerging Opportunities.","authors":"Alexandra Schmidt, James A Liggins, Haad Bhutta, Sharon D Dell, Janice M Leung, Don D Sin, Jonathon A Leipsic, Jonathan H Rayment, Rachel L Eddy","doi":"10.1148/ryct.240562","DOIUrl":"https://doi.org/10.1148/ryct.240562","url":null,"abstract":"<p><p>Hyperpolarized xenon 129 (¹²⁹Xe) MRI uses inhaled ¹²⁹Xe gas to visualize pulmonary function and microstructure. This review aims to summarize established and emerging quantitative measurements derived from ¹²⁹Xe MRI and MR spectroscopy (MRS) and illustrate their clinical applications in the characterization and management of cardiopulmonary diseases. They are well tolerated by adults and children with pulmonary disease, employ no ionizing radiation, and their measurements have been validated by correlation with pulmonary function tests in various cardiopulmonary diseases. ¹²⁹Xe fills unobstructed airspaces, producing three-dimensional maps of ventilation and enabling quantification of ventilation defects, dynamics, and heterogeneity. Leveraging ¹²⁹Xe's biologic solubility, gas exchange imaging and spectroscopy allow for quantification of gas transfer between airspaces, alveolar membrane, and red blood cells and are sensitive to blood oxygenation and vascular remodeling. Diffusion-weighted imaging quantifies airspace enlargement, providing models of alveolar microstructure. ¹²⁹Xe MRI can help detect early-stage disease, adding value where reference-standard tools, such as pulmonary function tests, lack sensitivity. The ability of ¹²⁹Xe MRI to assess function regionally creates opportunities for the detection of localized functional deficits and the improvement of image-guided interventions. Applications of ¹²⁹Xe MRI and MRS include planning treatment, monitoring disease progression and treatment response, and developing surrogate endpoints for clinical and therapeutic studies. <b>Keywords:</b> MR Imaging, MR Spectroscopy, Thorax, Lung, Hyperpolarized ¹²⁹Xe, MRI, MRS, Lung Function, Ventilation, Gas Exchange, Alveolar Microstructure © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240562"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head-to-Head Comparison between MRI and CT in the Evaluation of Volume and Quality of Epicardial Adipose Tissue.","authors":"Marjan Firouznia, David Molnar, Carl Edin, Ola Hjelmgren, Carl-Johan Östgren, Peter Lundberg, Markus Henningsson, Göran Bergström, Carl-Johan Carlhäll","doi":"10.1148/ryct.240531","DOIUrl":"10.1148/ryct.240531","url":null,"abstract":"<p><p>Purpose To systematically compare MRI- and CT-based measurements of both the volume and quality of epicardial adipose tissue (EAT). Materials and Methods This prospective study included participants from a subset of the Swedish CArdioPulmonary bioImage Study (SCAPIS) who underwent MRI and CT between November 2017 and July 2018. Dixon fat-water separation MR images were manually segmented, and a threshold-based approach based on a fat signal fraction (FSF) map was used to obtain the EAT volume. Within this EAT volume, the mean FSF was quantified as a measure of fat quality. EAT segmentation from CT images was performed using deep learning techniques, and the EAT volume and its mean attenuation were quantified. Correlation between MRI- and CT-based measurements of EAT volume and quality was assessed using the Pearson correlation coefficient. Results Ninety-two participants (mean age, 59 years ± 5 [SD]; 60 male participants) were included. The intermodality correlation for EAT volume was very strong (<i>r</i> = 0.92, <i>P</i> < .001), with systematically larger values for CT versus MRI (<i>P</i> < .001). There was a strong negative correlation between MRI FSF and CT attenuation (<i>r</i> = -0.72, <i>P</i> < .001). Repeatability analysis for assessment of MRI EAT volume showed good interreader agreement (intraclass correlation coefficient, 0.86) and excellent intrareader agreement (intraclass correlation coefficient, 0.96). Conclusion Correlation between MRI and CT was very strong for EAT volume and strong for EAT quality. <b>Keywords:</b> Cardiac, Adipose Tissue (Obesity Studies), Epicardial Fat, Heart, Tissue Characterization, Comparative Studies, Magnetic Resonance Imaging, Computed Tomography, Fat Signal Fraction, Fat Attenuation Published under a CC BY 4.0 license.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240531"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Myocardial Tissue Characterization Using Delayed-Phase Dynamic Contrast-enhanced Cardiac MRI.","authors":"Li-Ting Huang, Xinheng Zhang, Xinqi Li, Archana Malagi, Yuheng Huang, Xingmin Guan, Hao Ho, Alan Kwan, Janet Wei, Xiaoming Bi, Anthony G Christodoulou, Debiao Li, Hui Han, Yen-Wen Liu, Rohan Dharmakumar, Hsin-Jung Yang","doi":"10.1148/ryct.240393","DOIUrl":"https://doi.org/10.1148/ryct.240393","url":null,"abstract":"<p><p>Purpose To evaluate the performance of a delayed-phase dynamic contrast-enhanced (dDCE) MRI model in quantitative assessment of myocardial tissue physiology and late gadolinium enhancement (LGE) within 5 minutes after contrast material injection in reperfused myocardial infarction (MI). Materials and Methods This animal study included 11 canines (seven female) with reperfused MI. A dDCE model using dynamic postcontrast T1 maps was adopted to depict an unbiased contrast material washout process. The dDCE parameters derived from the 30-minute contrast material washout process (dDCE_30min) and a 5-minute image subset (dDCE_5min) were compared. LGE images were synthesized from the dDCE_5min maps (LGE_dDCE) and compared LGE extent and transmurality with the standard LGE images acquired at 15 minutes after contrast material injection (LGE_standard). Statistical analyses used paired tests for dependent group comparisons. Results The dDCE_30min map demonstrated that extravascular extracellular volume and capillary permeability surface area product were higher in MI regions than in remote myocardium (61.12% ± 13.65 [SD] vs 13.43% ± 5.00; <i>P</i> = .02; 5.08 mL × g-1 × min-1 ± 4.10 vs 0.42 mL × g-1 × min-1 ± 0.55; <i>P</i> = .02, respectively). There was no evidence of differences between dDCE_5min parameters and dDCE_30min parameters (all <i>P</i> > .05). There was also no evidence of a difference between LGE_dDCE and LGE_standard in LGE area (30.65% ± 11.94 vs 30.66% ± 11.94; <i>P</i> = .99) or transmurality (54.87% ± 15.57 vs 53.27% ± 15.98; <i>P</i> = .06), but LGE_dDCE demonstrated a higher contrast-to-noise ratio (14.62 ± 13.03 vs 1.41 ± 0.97; <i>P</i> < .01). The area under the receiver operating characteristic curve of MI detection using LGE_dDCE was 0.97 (95% CI: 0.94, >0.99), with 94.4% sensitivity and 96.7% specificity. Conclusion The developed dDCE MRI model for myocardial tissue assessment shows potential to enhance lesion contrast, quantify clinically relevant physiologic parameters, and support comprehensive evaluation of myocardial injury in heart disease. <b>Keywords:</b> Dynamic Contrast-enhanced MRI, Myocardial Infarction, MRI, Pharmacokinetics, Ischemic Heart Disease <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240393"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enlarging Epicardial Cardiac Hemangioma: Serial Multimodality Imaging and Pathologic Correlation.","authors":"Neel Vora, Patrick Collier, Carmela Tan, E Rene Rodriguez, Shinya Unai, Michael A Bolen","doi":"10.1148/ryct.250234","DOIUrl":"https://doi.org/10.1148/ryct.250234","url":null,"abstract":"<p><p>Cardiac hemangioma is an uncommon benign heart tumor. It can either be an incidental finding at imaging because of its asymptomatic nature, or it can present with symptoms such as dyspnea, angina, or arrhythmias. Multimodality noninvasive imaging can help delineate the tumor as well as guide management. This is a case of a patient with an incidental finding of a cardiac hemangioma who was managed with serial imaging for close to 15 years with demonstrable increase in size and associated symptoms leading to eventual surgical resection. <b>Keywords:</b> Cardiac, CT, Echocardiography, Cardiac Hemangioma, MRI, CT, Conservative Management, Surgery <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e250234"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4D Flow MRI of the Thoracic Aorta.","authors":"David Dushfunian, Sebastian Cohn, Haben Berhane, Michael Markl","doi":"10.1148/ryct.240532","DOIUrl":"https://doi.org/10.1148/ryct.240532","url":null,"abstract":"<p><p>Four-dimensional (4D) flow MRI has emerged as a versatile technique for the three-dimensional evaluation of blood flow dynamics, offering the ability to visualize flow patterns qualitatively and allow for the retrospective quantification of standard and advanced hemodynamic parameters. Recent advancements in 4D flow MRI technology, including optimized acquisition protocols and improved hemodynamic analysis workflow efficiency, have facilitated its integration into standard clinical practice, enhancing the accessibility and applicability of this innovative imaging modality. A growing body of studies have demonstrated its clinical value for monitoring and informing the management of aortic pathologies, cementing its role in modern cardiovascular care. In this review, the authors provide a concise overview of data acquisition techniques and hemodynamics analysis methods for 4D flow MRI, with a specific focus on the thoracic aorta. The core of this article explores the clinical applications of aortic 4D flow MRI in patients with aortic valve disease, aortopathy, coarctation, dissection, connective tissue disorders, and age-related changes. Furthermore, the authors discuss the emerging role of artificial intelligence on improving 4D flow MRI acquisition and processing efficiencies. <b>Keywords:</b> Aorta, MR-Imaging, Vascular, Aortic Valve, 4D Flow MRI, Phase-Contrast, Hemodynamics, Clinical Applications © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240532"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Pulmonary Graft Loss Using Oxygen-enhanced MRI T1 Mapping in a Prospective Study.","authors":"Milan Speth, Till F Kaireit, Marcel Gutberlet, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Frank Wacker, Jens Gottlieb, Jens Vogel-Claussen","doi":"10.1148/ryct.240274","DOIUrl":"https://doi.org/10.1148/ryct.240274","url":null,"abstract":"<p><p>Purpose To investigate the predictive efficacy of oxygen-enhanced MRI T1 mapping parameters for detecting chronic lung allograft dysfunction (CLAD)-related graft loss at 6-12 months and for an additional 2.5 years following pulmonary transplant over a 5.6-year observational interval. Materials and Methods In this single-center, longitudinal, and prospective study conducted between August 2013 and December 2018, parameters from oxygen-enhanced MRI T1 mapping (including oxygen transfer function [OTF], delta T1 oxygenated volume [OV]) were acquired from 141 clinically stable double-lung transplant recipients (6-12 months after transplant) and follow-up (2.5 years after baseline MRI). Applying Kaplan-Meier survival analysis and Cox proportional hazards model, all biomarkers were compared regarding the time to CLAD-related graft loss as the primary outcome measure. Results Participants (<i>n</i> = 141; mean age, 50 years ± 13 [SD], 76 men, 65 women) underwent baseline MRI, of which 132 were analyzed. Over the following 5.6-year observational period, 24 (18%) participants experienced graft loss related to CLAD. At baseline, oxygen-enhanced MRI parameters predicted graft loss within 5.6 years: delta T1 median (hazard ratio [HR], 3.50; 95% CI: 1.0, 9.4; <i>P</i> = .048), quartile coefficient of dispersion (HR, 3.43; 95% CI: 1.1, 8.7; <i>P</i> = .03), and delta T1 oxygenated volume (HR, 3.07; 95% CI 1.18, 7.22; <i>P</i> = .02), while OTF (<i>P</i> = .18) and spirometry (<i>P</i> = .32) did not. At follow-up (91 stable vs 11 graft loss), all parameter changes (follow-up/baseline value × 100 [%baseline]) predicted poorer survival: OTF (HR, 11.1; 95% CI: 2.5, 75.9; <i>P</i> = .001), delta T1 OV (HR, 6.47; 95% CI: 1.52, 27.53; <i>P</i> = .01), and forced expiratory volume in 1 second from spirometry (HR, 7.94; 95% CI: 2.16, 27.4; <i>P</i> = .003). Conclusion Oxygen-enhanced MRI parameters predict CLAD-related graft loss at 6-12 months following lung transplant and 2.5 years after baseline MRI. Delta T1 OV was the most consistent predictor of future graft loss. <b>Keywords:</b> MRI, Lung, Transplantation <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":"7 4","pages":"e240274"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}