Analysis of 4 dimensional phase contrast MRI by moving 3 dimensional model method in patients with Stanford B type aortic dissection
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Supported by Key Science and Technology Project of Haikou(2012-072).

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    Abstract:

    Objectives The aim of this study was to visualize and quantify the flow characteristics in both healthy and patients with Stanford B type aortic dissection. All deriving blood flow parameters from four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) were post-processed by moving three dimensional 3D model methods. Methods Moving 3D model of a blood vessel were captured from 4D PC-MRI. Determining a reference vascular cross-sectional plane and capturing the displacement contours information at the same plane were all used to determine the plurality of target vascular cross-sectional planes at multiple times. The plurality parameters of target vascular cross-sectional planes were determined by temporal tracking. The differences of flow characteristics both healthy (n=19) and patients (n=8) with Stanford B type aortic dissection were analyzed by 4D PC-MRI. Variables are expressed as median and inter quartile range (IQR). Sample means were compared using Mann-Whitney U test. A value of P≤0.05 was considered significant for all statistical tests. Results All 4D PC-MRI data were effectively post-processed by the moving 3D model methods. Qualitative blood flow visualization in the aorta of healthy volunteers showed laminar, without turbulences or vortex formation. In the ascending aorta there was a slight helical flow pattern, while there were little changes of wall shear stress in the entire thoracic aorta. Aortic remodeling and false lumen thrombosis of type Stanford B thoracic aortic dissection were determined by 4D PC-MRI and confirmed by T1 3D MRI anatomy scan. Blood flow in the false lumen was multidirectional and complex, with a high proportion of reverse flow, against the predominant aortic flow direction or true lumen. The peak velocity of blood flow in false lumen typically arrived earlier, while not in normal condition. Helical flow was seen mainly near the entry tear of false lumen with higher possibility. The stroke volume was greater in the true (54.3 ml,IQR 43.2—64.8 ml) compared with the false lumen (31.6 ml,IQR 19.8—47.6 ml,Mann-Whitney P<0.01). The majority of the flow in the true lumen was forward flow (91.4%,IQR 90.0%—94.2%), whereas the false lumen had a high proportion of backward flow (40.3%,IQR 23.2%—53.3%). Expansion rates were measured at the proximal and distal sites. The average velocity of blood flow in the false lumen (7.1 cm/s, IQR 4.9—9.8 cm/s) was less than the true lumen (18.0 cm/s,IQR 13.9—20.6 cm/s, Mann-Whitney P<0.01). (4) Maximum velocity occurred earlier in the cardiac cycle (false lumen, 166.0 ms (IQR 132.8—210.0) vs true lumen, 215.0 ms (IQR 196.3—249.0 ms,Mann-Whitney P<0.01). Helical flow was only seen in the false lumen and occurred in 8 of 10 patients,only seen in false lumen 6 of 8 patients. Helical flow typically developed in early-systole, at 158 ms (IQR 145—249 ms) after the R-wave, and lasted for 310 ms (IQR 217—537 ms). The maximum amount of rotation seen was 820° per cardiac cycle. Conclusion Moving 3D model methods were suited to visualize and quantify the flow characteristics and flow parameters from 4D PC-MRI. The changes of flow orientation, time to peak velocity, and helical flow are able to quantify the appearance and development of thoracic aortic dissection.

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History
  • Received:June 12,2013
  • Revised:August 04,2013
  • Adopted:March 19,2014
  • Online: September 22,2014
  • Published:
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