| 1. |
- Dyverfeldt, Petter, 1980-, et al.
(författare)
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Assessment of fluctuating velocities in disturbed cardiovascular blood flow : in vivo feasibility of generalized phase-contrast MRI
- 2008
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley. - 1053-1807 .- 1522-2586. ; 28:3, s. 655-663
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo evaluate the feasibility of generalized phase-contrast magnetic resonance imaging (PC-MRI) for the noninvasive assessment of fluctuating velocities in cardiovascular blood flow.Materials and MethodsMultidimensional PC-MRI was used in a generalized manner to map mean flow velocities and intravoxel velocity standard deviation (IVSD) values in one healthy aorta and in three patients with different cardiovascular diseases. The acquired data were used to assess the kinetic energy of both the mean (MKE) and the fluctuating (TKE) velocity field.ResultsIn all of the subjects, both mean and fluctuating flow data were successfully acquired. The highest TKE values in the patients were found at sites characterized by abnormal flow conditions. No regional increase in TKE was found in the normal aorta.ConclusionPC-MRI IVSD mapping is able to detect flow abnormalities in a variety of human cardiovascular conditions and shows promise for the quantitative assessment of turbulence. This approach may assist in clarifying the role of disturbed hemodynamics in cardiovascular diseases.
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| 2. |
- Dyverfeldt, Petter, et al.
(författare)
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Hemodynamic aspects of mitral regurgitation assessed by generalized phase-contrast MRI
- 2011
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Ingår i: Journal of Magnetic Resonance Imaging. - : John Wiley and Sons. - 1053-1807 .- 1522-2586. ; 33:3, s. 582-588
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Mitral regurgitation creates a high velocity jet into the left atrium (LA), contributing both volume andpressure; we hypothesized that the severity of regurgitation would be reflected in the degree of LA flowdistortion.Material and Methods: Three-dimensional cine PC-MRI was applied to determine LA flow patterns andturbulent kinetic energy (TKE) in seven subjects (five patients with posterior mitral leaflet prolapse, two normalsubjects). In addition, the regurgitant volume and the time-velocity profiles in the pulmonary veins weremeasured.Results: The LA flow in the mitral regurgitation patients was highly disturbed with elevated values of TKE.Peak TKE occurred consistently at late systole. The total LA TKE was closely related to the regurgitant volume.LA flow patterns were characterized by a pronounced vortex in proximity to the regurgitant jet. In some patients,pronounced discordances were observed between individual pulmonary venous inflows, but these could not berelated to the direction of the flow jet or parameters describing global LA hemodynamics.Conclusion: PC-MRI permits investigations of atrial and pulmonary vein flow patterns and TKE in significantmitral regurgitation, reflecting the impact of the highly disturbed blood flow that accompanies this importantvalve disease.
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| 3. |
- Dyverfeldt, Petter, et al.
(författare)
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Reduction of motion artifacts in carotid MRI using free-induction decay navigators
- 2014
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Ingår i: Journal of Magnetic Resonance Imaging. - : John Wiley & Sons. - 1053-1807 .- 1522-2586. ; 40:1, s. 214-220
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To develop a framework for prospective free-induction decay (FID)-based navigator gating for suppression of motion artifacts in carotid magnetic resonance imaging (MRI) and to assess its capability in vivo.MATERIALS AND METHODS:An FID-navigator, comprising a spatially selective low flip-angle sinc-pulse followed by an analog-to-digital converter (ADC) readout, was added to a conventional turbo spin-echo (TSE) sequence. Real-time navigator processing delivered accept/reject-and-reacquire decisions to the sequence. In this Institutional Review Board (IRB)-approved study, seven volunteers were scanned with a 2D T2-weighted TSE sequence. A reference scan with volunteers instructed to minimize motion as well as nongated and gated scans with volunteers instructed to perform different motion tasks were performed in each subject. Multiple image quality measures were employed to quantify the effect of gating.RESULTS:There was no significant difference in lumen-to-wall sharpness (2.3 ± 0.3 vs. 2.3 ± 0.4), contrast-to-noise ratio (CNR) (9.0 ± 2.0 vs. 8.5 ± 2.0), or image quality score (3.1 ± 0.9 vs. 2.6 ± 1.2) between the reference and gated images. For images acquired during motion, all image quality measures were higher (P < 0.05) in the gated compared to nongated images (sharpness: 2.3 ± 0.4 vs. 1.8 ± 0.5, CNR: 8.5 ± 2.0 vs. 7.2 ± 2.0, score: 2.6 ± 1.2 vs. 1.8 ± 1.0).CONCLUSION:Artifacts caused by the employed motion tasks deteriorated image quality in the nongated scans. These artifacts were alleviated with the proposed FID-navigator.
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| 4. |
- Escobar Kvitting, John-Peder, et al.
(författare)
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In Vitro Assessment of Flow Patterns and Turbulence Intensity in Prosthetic Heart Valves Using Generalized Phase-Contrast MRI
- 2010
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Ingår i: JOURNAL OF MAGNETIC RESONANCE IMAGING. - : John Wiley and Sons, Ltd. - 1053-1807 .- 1522-2586. ; 31:5, s. 1075-1080
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess in vitro the three-dimensional mean velocity field and the extent and degree of turbulence intensity (TI) in different prosthetic heart valves using a generalization of phase-contrast MRI (PC-MRI). Materials and Methods: Four 27-mm aortic valves (Bjork-Shiley Monostrut tilting-disc, St. Jude Medical Standard bileaflet, Medtronic Mosaic stented and Freestyle stentless porcine valve) were tested under steady inflow conditions in a Plexiglas phantom. Three-dimensional PC-MRI data were acquired to measure the mean velocity field and the turbulent kinetic energy (TKE), a direction-independent measure of TI. Results: Velocity and TI estimates could be obtained up and downstream of the valves, except where metallic structure in the valves caused signal void. Distinct differences in the location, extent, and peak values of velocity and TI were observed between the valves tested. The maximum values of TKE varied between the different valves: tilting disc, 100 J/m(3); bileaflet, 115 J/m(3); stented, 200 J/m(3); stentless, 145 J/m(3). Conclusion: The TI downstream from a prosthetic heart valve is dependent on the specific valve design. Generalized PC-MRI can be used to quantify velocity and TI downstream from prosthetic heart valves, which may allow assessment of these aspects of prosthetic valvular function in postoperative patients.
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| 5. |
- Fredriksson, Alexandru Grigorescu, et al.
(författare)
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4D flow MRI can detect subtle right ventricular dysfunction in primary left ventricular disease.
- 2016
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley-Blackwell. - 1053-1807 .- 1522-2586. ; 43:3, s. 558-565
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate whether 4D flow magnetic resonance imaging (MRI) can detect subtle right ventricular (RV) dysfunction in primary left ventricular (LV) disease.MATERIALS AND METHODS: 4D flow and morphological 3T MRI data were acquired in 22 patients with mild ischemic heart disease who were stratified into two groups based on LV end-diastolic volume index (EDVI): lower-LVEDVI and higher-LVEDVI, as well as in 11 healthy controls. The RV volume was segmented at end-diastole (ED) and end-systole (ES). Pathlines were emitted from the ED volume and traced forwards and backwards in time to ES. The blood volume was separated into flow components. The Direct Flow (DF) component was defined as RV inflow passing directly to outflow. The kinetic energy (KE) of the DF component was calculated. Echocardiographic conventional RV indices were also assessed.RESULTS: The higher-LVEDVI group had larger LVEDVI and lower LV ejection fraction (98 ± 32 ml/m(2) ; 48 ± 13%) compared to the healthy (67 ± 12, P = 0.002; 64 ± 7, P < 0.001) and lower-LVEDI groups (62 ± 10; 68 ± 7, both P < 0.001). The RV 4D flow-specific measures "DF/EDV volume-ratio" and "DF/EDV KE-ratio at ED" were lower in the higher-LVEDVI group (38 ± 5%; 52 ± 6%) compared to the healthy (44 ± 6; 65 ± 7, P = 0.018 and P < 0.001) and lower-LVEDVI groups (44 ± 6; 64 ± 7, P = 0.011 and P < 0.001). There was no difference in any of the conventional MRI and echocardiographic RV indices between the three groups.CONCLUSION: We found that in primary LV disease mild impairment of RV function can be detected by 4D flow-specific measures, but not by the conventional MRI and echocardiographic indices. J. Magn. Reson. Imaging 2015.
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| 6. |
- Fredriksson, Alexandru Grigorescu, et al.
(författare)
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Turbulent kinetic energy in the right ventricle : Potential MR marker for risk stratification of adults with repaired Tetralogy of Fallot
- 2018
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Ingår i: Journal of Magnetic Resonance Imaging. - Hoboken : John Wiley & Sons. - 1053-1807 .- 1522-2586. ; 47:4, s. 1043-1053
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess right ventricular (RV) turbulent kinetic energy (TKE) in patients with repaired Tetralogy of Fallot (rToF) and a spectrum of pulmonary regurgitation (PR), as well as to investigate the relationship between these 4D flow markers and RV remodeling.Materials and Methods: Seventeen patients with rToF and 10 healthy controls were included in the study. Patients were divided into two groups based on PR fraction: one lower PR fraction group (11%) and one higher PR fraction group (>11%). Field strength/sequences: 3D cine phase contrast (4D flow), 2D cine phase contrast (2D flow), and balanced steady-state free precession (bSSFP) at 1.5T. Assessment: The RV volume was segmented in the morphologic short-axis images and TKE parameters were computed inside the segmented RV volume throughout diastole. Statistical tests: One-way analysis of variance with Bonferroni post-hoc test; unpaired t-test; Pearson correlation coefficients; simple and stepwise multiple regression models; intraclass correlation coefficient (ICC).Results: The higher PR fraction group had more remodeled RVs (140 6 25 vs. 107 6 22 [lower PR fraction, P < 0.01] and 93 6 15 ml/m2[healthy, P < 0.001] for RV end-diastolic volume index [RVEDVI]) and higher TKE values (5.95 6 3.15 vs. 2.23 6 0.81 [lower PR fraction, P < 0.01] and 1.91 6 0.78 mJ [healthy, P < 0.001] for Peak Total RV TKE). Multiple regression analysis between RVEDVI and 4D/2D flow parameters showed that Peak Total RV TKE was the strongest predictor of RVEDVI (R25 0.47, P 5 0.002).Conclusion: The 4D flow-specific TKE markers showed a slightly stronger association with RV remodeling than conventional 2D flow PR parameters. These results suggest novel hemodynamic aspects of PR in the development of late complications after ToF repair.
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| 7. |
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| 8. |
- Good, Elin, 1983-, et al.
(författare)
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Quantitative Magnetic Resonance Imaging Assessment of the Relationships Between Fat Fraction and R2*Inside Carotid Plaques, and Circulating Lipoproteins
- 2022
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley. - 1053-1807 .- 1522-2586. ; 55:4, s. 1260-1270
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Tidskriftsartikel (refereegranskat)abstract
- Background Lipid-rich necrotic core (LRNC) and intraplaque hemorrhage (IPH) are morphological features of high-risk atherosclerotic plaques. However, their relationship to circulating lipoproteins is unclear. Purpose To study associations between changes in lipoproteins vs. changes in LRNC (represented by fat fraction [FF]) and IPH (represented by R2*). Study Type Prospective. Subjects Fifty-two patients with carotid plaques, 33 males (63.5%), mean age 72 (+/- 5). Field Strength/Sequence Four-point fast gradient Dixon magnetic resonance imaging (MRI) was used to quantify FF and R2* (to measure IPH) inside plaques and in vessel wall. Turbo-spin echo was used for T-1 weighted sequences to guide manual segmentation. Assessment Carotid MRI and serum lipid levels were assessed at baseline and at 1-year follow-up. For patients, lipid-lowering therapy was customized to reduce low-density lipoprotein (LDL) levels below 1.8 mmol/L. Segmentation was performed with one set of regions of interest for the plaque and one for the vessel wall at the location of the plaque. Thereby MRI data for FF, R2*, and volumes in plaque- and vessel-wall segmentations could be obtained from baseline and follow-up, as well as changes over the study year. Statistical Tests Pearson correlation coefficient for correlations. Paired samples t-test for changes over time. Significance at P < 0.05, 95% confidence interval. Results LDL decreased significantly (2.19-1.88 mmol/L, Z - 2.9), without correlation to changes in plaque composition, nor to the significant reduction in vessel-wall volume (-106.3 mm(3)). Plaque composition remained unchanged, FF +8.5% (P = 0.366) and R2* +3.5% (P = 0.304). Compared to plaque segmentations, R2* was significantly lower in the vessel-wall segmentations both at baseline (-9.3%) and at follow-up (-9.1%). Data Conclusion The absence of correlations between changes in lipoproteins and changes in plaque composition indicates more complex relationships between these parameters than previously anticipated. The significant differences in both R2* and volume dynamics comparing plaque segmentations and vessel-wall segmentations suggest differences in their pathobiology of atherosclerosis. Level of Evidence 1 Technical Efficacy Stage 4
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| 9. |
- Petersson, Sven, et al.
(författare)
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Assessment of the accuracy of MRI wall shear stress estimation using numerical simulations
- 2012
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley-Blackwell. - 1053-1807 .- 1522-2586. ; 36:1, s. 128-138
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the accuracy of wall shear stress (WSS) estimation using MRI. Specifically, to investigate the impact of different parameters and if MRI WSS estimates are monotonically related to actual WSS. Materials and Methods: The accuracy of WSS estimation using methods based on phase-contrast (PC) MRI velocity mapping, Fourier velocity encoding (FVE) and intravoxel velocity standard deviation mapping were studied using numerical simulations. The influence of spatial resolution, velocity encoding, wall segmentation, and voxel location were investigated over a range of WSS values. Results: WSS estimates were found to be sensitive to parameter settings in general and spatial resolution in particular. All methods underestimated WSS, except for the FVE-based method, which instead was extremely sensitive to voxel position relative to the wall. Methods using PC-based WSS estimation with wall segmentation showed to be accurate for low WSS, but were sensitive to segmentation errors. Conclusion: Even in the absence of noise and for relatively simple velocity profiles, MRI WSS estimates cannot always be assumed to be linearly or even monotonically related to actual WSS. High WSS values cannot be resolved and the estimates depend on parameter setting. Nevertheless, distinguishing areas of low and moderate WSS may be feasible.
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| 10. |
- Sigovan, Monica, et al.
(författare)
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Comparison of four-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta
- 2011
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Ingår i: Journal of Magnetic Resonance Imaging. - : John Wiley & Sons. - 1053-1807 .- 1522-2586. ; 34:5, s. 1226-1230
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To compare quantitative parameters for assessing the degree of eccentric systolic blood flow in the ascending thoracic aorta (AsAo).Materials and Methods:Forty-one patients were studied with three-dimensional (3D), cine phase-contract MRI (4D Flow). Analysis was performed at peak systole for a cross-sectional plane in the AsAo just distal to the sinotubular junction. AsAo flow was graded as normal, mildly, or markedly eccentric based on qualitative visual assessment. For quantitative analysis, flow jet angle and normalized flow displacement from the vessel center were calculated.Results:Patients with normal AsAo systolic flow (n = 25) had an average flow jet angle of 13.7 degrees and flow displacement 0.04. These parameters were significantly elevated for patients with mild eccentric systolic flow (n = 6): 24.6 degrees (P = 0.012) and 0.12 (P = 0.001), respectively. However, for patients with marked eccentric flow (n = 10), only flow displacement was significantly elevated compared with the mild eccentric group (0.18; P = 0.04); flow angle was 25.7 degrees.Conclusion:Flow displacement is a more reliable quantitative parameter for measuring eccentric AsAo systolic flow than flow jet angle, and should be evaluated in studies investigating the role of eccentric flow in the promotion of aortic pathology.
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