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Retrospectively Gated Intra-cardiac 4D Flow MRI using Spiral Trajectories
Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Center for Medical Image Science and Visualization (CMIV). Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.ORCID iD: 0000-0003-2198-9690
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2016 (English)In: Magnetic Resonance in Medicine, ISSN 0740-3194, E-ISSN 1522-2594, Vol. 75, no 1, 196-206 p.Article in journal (Refereed) Published
Abstract [en]

Background: Four-dimensional (4D) flow MRI is a powerful tool for the quantification of blood flow and enables calculation of a range of unique hemodynamic parameters. However, the application of cardiac 4D flow MRI is limited by long scan times (20-40 minutes). The high efficiency of spiral readouts can be used to reduce scan times without sacrificing SNR. The aim of this work was to develop and validate a retrospectively gated 4D flow MRI sequence using spiral readouts for the measurement of intra-cardiac velocities.

Methods: A retrospectively ECG gated 4D flow sequence using stacks of spiral readouts was implemented on a clinical 1.5 T MRI scanner. The spiral 4D flow MRI sequence was validated in-vivo by comparisons with a two-dimensional (2D) through-plane velocity measurement and a conventional Cartesian 4D flow acquisition (SENSE factor 2) in 7 healthy volunteers (age 27 ± 3 years, four men) and 2 patients (age 19 and 52, women, only spiral 4D flow and 2D). Net volume flow was estimated from all three acquisition approaches and compared using one-way ANOVA. A quantitative pathline based validation was performed on the Cartesian and the spiral 4D flow MRI acquisitions by comparing the left ventricular inflow and outflow (two-tailed paired t-tests).

Results: The scan time of the spiral 4D flow sequence was 44±6% of the Cartesian counterpart. Compared to time-resolved 2D flow in the aorta, the spiral and Cartesian 4D flow acquisitions provided similarly good data, as there was no significant difference between the net volume flow for all acquisitions (Spiral: 89±14 ml, Cartesian: 93±11 ml, 2D: 93±18 ml, p=0.878). There was no significant difference between pathline-based calculations of inflow and outflow with either Cartesian (In: 88±15, Out: 85±16, p = 0.168) or spiral (In: 93±17 ml, Out: 84±18, p = 0.055) 4D flow acquisitions.

Conclusions: Retrospectively gated spiral cardiac 4D flow MRI permits more than two-fold reduction in scan time compared to conventional Cartesian 4D flow MRI without notable loss in data quality. The time-savings offered by spiral trajectories could provide a step towards the expanded clinical use of 4D flow MRI.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016. Vol. 75, no 1, 196-206 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-101103DOI: 10.1002/mrm.25612ISI: 000367739200019OAI: oai:DiVA.org:liu-101103DiVA: diva2:665277
Note

Funding agencies: European Research Council [310612]; Swedish Research Council; Swedish Heart and Lung foundation

Available from: 2013-11-19 Created: 2013-11-19 Last updated: 2017-05-03Bibliographically approved
In thesis
1. Fast and Accurate 4D Flow MRI for Cardiovascular Blood Flow Assessment
Open this publication in new window or tab >>Fast and Accurate 4D Flow MRI for Cardiovascular Blood Flow Assessment
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The study of blood flow is essential in understanding the physiology and pathophysiology of the cardiovascular system. Small disturbances of the blood flow may over time evolve and contribute to cardiovascular pathology. While the blood flow in a healthy human appears to be predominately laminar, turbulent or transitional blood flow is thought to be involved in the pathogenesis of several cardiovascular diseases. Wall shear stress is the frictional force of blood on the vessel wall and has been linked to the pathogenesis of atherosclerosis and aneurysms. Despite the importance of hemodynamic factors, cardiovascular diagnostics largely relies on the indirect estimation of function based on morphological data.

Time-resolved three-dimensional (3D) phase-contrast magnetic resonance imaging (MRI), often referred to as 4D flow MRI, is a versatile and non-invasive tool for cardiovascular blood flow assessment. The use of 4D flow MRI permits estimation of flow volumes, pressure losses, wall shear stress, turbulence intensity and many other unique hemodynamic parameters. However, 4D flow MRI suffers from long scan times, sometimes over 40 minutes. Furthermore, the accuracy of the many different 4D flow MRI-based applications and estimates have not been thoroughly examined.

In this thesis, the accuracy of 4D flow MRI-based turbulence intensity mapping and wall shear stress estimation was investigated by using numerical simulations of MRI flow measurements. While the results from the turbulence intensity mapping agreed well with reference values from computational fluid dynamics data, the accuracy of the MRI-based wall shear stress estimates was found to be very sensitive to different parameters, especially to spatial resolution, and wall shear stress values over 5 N/m2 were not well resolved.

To reduce the scan time, a 4D flow MRI sequence using spiral k-space trajectories was implemented and validated in-vivo and in-vitro. The scan time of 4D flow MRI was reduced by more than two-fold compared to a conventional Cartesian acquisition already accelerated using SENSE factor 2, and the data quality was maintained. For a 4D flow scan of the human heart, the use of spiral k-space trajectories resulted in a scan time of around 13 min, compared to 30 min for the Cartesian acquisition. By combining parallel imaging and spiral trajectories, the total scan time of a 4D flow measurement of the entire heart may be further reduced. This scan time reduction may also be traded for higher spatial resolution.

Numerical simulation of 4D flow MRI may act as an important tool for future optimization and validation of the spiral 4D flow sequence. The scan-time reductions offered by the spiral k-space trajectories can help to cut costs, save time, reduce discomfort for the patient as well as to decrease the risk for motion artifacts. These benefits may facilitate an expanded clinical and investigative use of 4D flow MRI, including larger patient research studies.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1380
National Category
Medical Engineering
Identifiers
urn:nbn:se:liu:diva-100146 (URN)10.3384/diss.diva-100146 (DOI)978-91-7519-506-3 (ISBN)
Public defence
2013-12-13, Berzeliussalen, Campus Valla, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2013-11-07 Created: 2013-10-29 Last updated: 2013-11-19Bibliographically approved

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Petersson, SvenSigfridsson, AndreasDyverfeldt, PetterCarlhäll, Carl-JohanEbbers, Tino

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Faculty of Health SciencesCenter for Medical Image Science and Visualization (CMIV)Division of Cardiovascular MedicineDepartment of Clinical Physiology in LinköpingFaculty of Medicine and Health SciencesDepartment of Clinical Physiology in Linköping
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