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Visualizing and quantifying flow stasis in abdominal aortic aneurysms in men using 4D flow MRI
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.ORCID-id: 0000-0001-9184-9234
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.ORCID-id: 0000-0003-1942-7699
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
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2019 (Engelska)Ingår i: Magnetic Resonance Imaging, ISSN 0730-725X, E-ISSN 1873-5894, Vol. 57, s. 103-110Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: To examine methods for visualizing and quantifying flow stasis in abdominal aortic aneurysms (AAA) using 4D Flow MRI. Methods: Three methods were investigated: conventional volumetric residence time (VRT), mean velocity analysis (MVA), and particle travel distance analysis (TDA). First, ideal 4D Flow MRI data was generated using numerical simulations and used as a platform to explore the effects of noise and background phase-offset errors, both of which are common 4D Flow MRI artifacts. Error-free results were compared to noise or offset affected results using linear regression. Subsequently, 4D Flow MRI data for thirteen (13) subjects with AAA was acquired and used to compare the stasis quantification methods against conventional flow visualization. Results: VRT (R-2 = 0.69) was more sensitive to noise than MVA (R-2 = 0.98) and TDA (R-2 = 0.99) at typical noncontrast signal-to-noise ratio levels (SNR = 20). VRT (R-2 = 0.14) was more sensitive to background phase-offsets than MVA (R-2 = 0.99) and TDA (R-2 = 0.96) when considering a 95% effective background phase-offset correction. Qualitatively, TDA outperformed MVA (Wilcoxon p amp;lt; 0.005, mean score improvement 1.6/5), and had good agreement (median score 4/5) with flow visualizations. Conclusion: Flow stasis can be quantitatively assessed using 4D Flow MRI. While conventional residence time calculations fail due to error accumulation as a result of imperfect measured velocity fields, methods that do not require lengthy particle tracking perform better. MVA and TDA are less sensitive to measurement errors, and TDA generates results most similar to those obtained using conventional flow visualization.

Ort, förlag, år, upplaga, sidor
ELSEVIER SCIENCE INC , 2019. Vol. 57, s. 103-110
Nyckelord [en]
Abdominal aortic aneurysm; Hemodynamics; 4D flow MRI; Flow stasis
Nationell ämneskategori
Medicinsk laboratorie- och mätteknik
Identifikatorer
URN: urn:nbn:se:liu:diva-154524DOI: 10.1016/j.mri.2018.11.003ISI: 000458096100012PubMedID: 30445146OAI: oai:DiVA.org:liu-154524DiVA, id: diva2:1290550
Tillgänglig från: 2019-02-20 Skapad: 2019-02-20 Senast uppdaterad: 2020-01-14
Ingår i avhandling
1. Improving Assessments of Hemodynamics and Vascular Disease
Öppna denna publikation i ny flik eller fönster >>Improving Assessments of Hemodynamics and Vascular Disease
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Blood vessels are more than simple pipes, passively enabling blood to pass through them. Their form and function are dynamic, changing with both aging and disease. This process involves a feedback loop wherein changes to the shape of a blood vessel affect the hemodynamics, causing yet more structural adaptation. This feedback loop is driven in part by the hemodynamic forces generated by the blood flow, and the distribution and strength of these forces appear to play a role in the initiation, progression, severity, and the outcome of vascular diseases.

Magnetic Resonance Imaging (MRI) offers a unique platform for investigating both the form and function of the vascular system. The form of the vascular system can be examined using MR-based angiography, to generate detailed geometric analyses, or through quantitative techniques for measuring the composition of the vessel wall and atherosclerotic plaques. To complement these analyses, 4D Flow MRI can be used to quantify the functional aspect of the vascular system, by generating a full time-resolved three-dimensional velocity field that represents the blood flow.

This thesis aims to develop and evaluate new methods for assessing vascular disease using novel hemodynamic markers generated from 4D Flow MRI and quantitative MRI data towards the larger goal of a more comprehensive non-invasive examination oriented towards vascular disease. In Paper I, we developed and evaluated techniques to quantify flow stasis in abdominal aortic aneurysms to measure this under-explored aspect of aneurysmal hemodynamics. In Paper II, the distribution and intensity of turbulence in the aorta was quantified in both younger and older men to understand how aging changes this aspect of hemodynamics. A method to quantify the stresses generated by turbulence that act on the vessel wall was developed and evaluated using simulated flow data in Paper III, and in Paper V this method was utilized to examine the wall stresses of the carotid artery. The hemodynamics of vascular disease cannot be uncoupled from the anatomical changes the vessel wall undergoes, and therefore Paper IV developed and evaluated a semi-automatic method for quantifying several aspects of vessel wall composition. These developments, taken together, help generate more valuable information from imaging data, and can be pooled together with other methods to form a more comprehensive non-invasive examination for vascular disease.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2019. s. 64
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1675
Nationell ämneskategori
Medicinsk bildbehandling Biomedicinsk laboratorievetenskap/teknologi
Identifikatorer
urn:nbn:se:liu:diva-156311 (URN)10.3384/diss.diva-156311 (DOI)9789176850985 (ISBN)
Disputation
2019-05-31, Hugo Theorell, Norra Entrén, Campus US, Linköping, 13:00 (Engelska)
Opponent
Handledare
Forskningsfinansiär
Vetenskapsrådet, 2013-06077Vetenskapsrådet, 2017-03857Region Östergötland, LIO-752951
Tillgänglig från: 2019-04-17 Skapad: 2019-04-12 Senast uppdaterad: 2019-04-24Bibliografiskt granskad

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