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Title Comparison of pulmonary flow measurements between four-dimensional whole-heart and two-dimensional phase-contrast MRI |
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Type Free Paper Session 3 |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Basic Science |
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Main Author Xiaodan Zhao1 |
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Presenting Author Xiaodan Zhao1 |
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Co-Author Jun-Mei Zhang1 3 Ru San Tan2 3 Shuo Zhang4 Rob van der Geest5 Ju Le Tan2 3 Ping Chai6 9 Lynette Teo7 9 Marielle V Fortier3 8 Teng Hong Tan3 8 Shuang Leng1 Wen Ruan2 Jennifer Ann Bryant1 Jonathan Yap2 Ching Ching Ong7 Devinder Singh6 9 Soo Teik Lim2 3 James W. Yip6 9 Liang Zhong1 3 |
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Department / Institution / Country National Heart Research Institute Singapore / National Heart Centre Singapore / Singapore1 Department of Cardiology / National Heart Centre Singapore / Singapore2 Duke-NUS Medical School / National University of Singapore / Singapore3 Department of Diagnostic and Interventional Radiology / University Hospital Aachen, RWTH Aachen University / Germany (Deutschland)4 Department of Radiology / Leiden University Medical Center / Netherlands5 Department of Cardiology / National University Heart Centre / Singapore6 Department of Diagnostic Imaging / National University Hospital / Singapore7 Department of Diagnostic & Interventional Imaging / KK Women’s and Children’s Hospital / Singapore8 Department of Medicine, Yong Loo Lin School of Medicine / National University of Singapore / Singapore9 |
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Objective(s) 4D whole-heart phase-contrast magnetic resonance imaging (PC-MRI) simultaneously quantifies intracardiac flow velocities and directions in any arbitrary orientations within the imaging volume that can later be reconstituted in any desired plane. We aimed to compare main pulmonary artery (PA) flow by using conventional 2D PC-MRI at a pre-subscribed plane with 4D PC-MRI in healthy volunteers and patients with heart disease. |
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Material and Method 21 healthy volunteers, 7 patients with repaired tetralogy of Fallot and 4 with pulmonary hypertension were recruited. All subjects underwent standard 2D-PC MRI (typical frame rate 30/heart beat) acquisition at a plane transecting the mid PA. 4D PC-MRI was performed using gradient-echo echo-planar imaging (EPI) with velocity encoding in three orthogonal directions (same number of cardiac phases) covering the heart from apex to aortic arch with subject freely breathing without respiratory navigation. 2D and 4D PA flow measurements were compared using intra-class correlation coefficients (ICC) and Bland-Altman analyses. |
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Result(s) PA flows and pulmonary regurgitation fractions (PRF) from 4D and 2D PC-MRI demonstrated good correlation (net forward flow 64.1 ± 16.1 vs. 62.7 ± 14.8mL, ICC 0.951; backward flow 8.6 ± 17.9 vs. 7.8 ± 15.5mL, ICC 0.990; PRF 9.1 ± 16.9 vs. 8.5 ± 14.8%, ICC 0.988) and agreement (means ± standard deviations of the differences in PA net forward flow, backward flow and PRF were 1.44 ± 6.67 mL, 0.8 ± 3.31 mL and 0.62 ± 3.45%, respectively). |
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Conclusion 4D whole-heart PC-MRI has excellent agreement with the standard 2D approach for PA flow quantitation. Compared to standard 2D-PC MRI, 4D-PC MRI encompasses more abundant information that may allow quantitation of downstream pulmonary artery wall shear stress, pulmonary vascular remodelling and assessment of disease progression and therapeutic response. |