Hermann Körperich1, Peter Barth2, Jürgen Gieseke3, Katja Müller4, Wolfgang Burchert2, Hermann Esdorn2, Deniz Kececioglu4, Philipp Beerbaum5, Kai Thorsten Laser4. 1. Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Georgstraße 11, D-32545 Bad Oeynhausen, Germany hkoerperich@hdz-nrw.de. 2. Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center Northrhine-Westfalia, Ruhr-University of Bochum, Georgstraße 11, D-32545 Bad Oeynhausen, Germany. 3. Philips Healthcare, Hamburg, Germany. 4. Center for Congenital Heart Defects, Heart and Diabetes Centre Northrhine-Westfalia, Ruhr-University of Bochum, Bad Oeynhausen, Germany. 5. Medizinische Hochschule Hannover, Kinderheilkunde, Pädiatrische Kardiologie und Pädiatrische Intensivmedizin, Hannover, Germany.
Abstract
AIMS: Blood flow rate quantification using two-dimensional phase-contrast MRI (PC-MRI) results in averaging of flow information due to long acquisition times precluding the examination of short-term effects. The aim of this study was to determine respiration-related flow rate variations by non-electrocardiographic triggered real-time phase-contrast MRI (PC-MRI). METHODS AND RESULTS: Real-time PC-MRI was applied to study respiration-driven blood flow fluctuations in the ascending aorta (AAo), superior vena cava (SVC), and inferior vena cava (IVC) under normal and forced breathing in 33 healthy children and 10 Fontan patients. Respiration-dependent flow rates were virtually generated by dividing the respiration curve into four segments: expiration, end-expiration, inspiration, and end-inspiration. Whereas in volunteers aortic flow rate was elevated during end-expiration (5.6 ± 3.0%) and decreased during end-inspiration (-5.8 ± 3.5%) in relation to mean blood flow (P < 0.05), highest flow was detected during inspiration in SVC (10.5 ± 14.1%) and IVC (22.5 ± 12.1%) and lowest flow during expiration (-11.6 ± 13.5%, -13.2 ± 14.1%, P < 0.05). Differences were increased under forced breathing in AAo (10.4 ± 5.5%, -7.4 ± 6.5%, P < 0.05) and SVC (40.0 ± 30.3%, -30.0 ± 19.2%, P < 0.05), whereas were unchanged in IVC (16.5 ± 23.6%, -13.7 ± 21.6%, P = n.s.). Regarding patients, respiratory-dependent flow rate variability was increased and had to be related to the patient's individual quality of Fontan circulation. CONCLUSION: Real-time PC-MRI allows a physiological assessment of respiratory-related flow rate fluctuations in healthy subjects as well as in Fontan patients. Its capability for detection of short-term effects in clinical routine was demonstrated. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Blood flow rate quantification using two-dimensional phase-contrast MRI (PC-MRI) results in averaging of flow information due to long acquisition times precluding the examination of short-term effects. The aim of this study was to determine respiration-related flow rate variations by non-electrocardiographic triggered real-time phase-contrast MRI (PC-MRI). METHODS AND RESULTS: Real-time PC-MRI was applied to study respiration-driven blood flow fluctuations in the ascending aorta (AAo), superior vena cava (SVC), and inferior vena cava (IVC) under normal and forced breathing in 33 healthy children and 10 Fontan patients. Respiration-dependent flow rates were virtually generated by dividing the respiration curve into four segments: expiration, end-expiration, inspiration, and end-inspiration. Whereas in volunteers aortic flow rate was elevated during end-expiration (5.6 ± 3.0%) and decreased during end-inspiration (-5.8 ± 3.5%) in relation to mean blood flow (P < 0.05), highest flow was detected during inspiration in SVC (10.5 ± 14.1%) and IVC (22.5 ± 12.1%) and lowest flow during expiration (-11.6 ± 13.5%, -13.2 ± 14.1%, P < 0.05). Differences were increased under forced breathing in AAo (10.4 ± 5.5%, -7.4 ± 6.5%, P < 0.05) and SVC (40.0 ± 30.3%, -30.0 ± 19.2%, P < 0.05), whereas were unchanged in IVC (16.5 ± 23.6%, -13.7 ± 21.6%, P = n.s.). Regarding patients, respiratory-dependent flow rate variability was increased and had to be related to the patient's individual quality of Fontan circulation. CONCLUSION: Real-time PC-MRI allows a physiological assessment of respiratory-related flow rate fluctuations in healthy subjects as well as in Fontan patients. Its capability for detection of short-term effects in clinical routine was demonstrated. Published on behalf of the European Society of Cardiology. All rights reserved.
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