Florian Siedek1, Daniel Giese2, Kilian Weiss3, Sandra Ekdawi2, Sebastian Brinkmann4, Wolfgang Schroeder4, Christiane Bruns4, De-Hua Chang2, Thorsten Persigehl2, David Maintz2, Stefan Haneder2. 1. Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. Electronic address: florian.siedek@uk-koeln.de. 2. Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. 3. Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Philips Healthcare Germany, Hamburg, Germany. 4. Department of General, Visceral and Tumor Surgery, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
Abstract
PURPOSE: This study aims to assess the feasibility of 4D flow MRI measurements in complex vascular territories; namely, the celiac artery (CA) and superior mesenteric artery (SMA). MATERIALS AND METHODS: In this prospective study, 22 healthy volunteers and 10 patients were scanned at 3 T. Blood flow parameters were compared between healthy volunteers and patients with stenosis of the CA and/or SMA as a function of stenosis grade characterized by prior contrast-enhanced computed tomography (CE-CT). The 4D flow MRI acquisition covered the CA, SMA and adjusting parts of the abdominal aorta (AO). Measurements of velocity- (peak velocity [PV], average velocity [AV]) and volume-related parameters (peak flow [PF], stroke volume [SV]) were conducted. Further, stenosis grade and wall shear stress in the CA, SMA and AO were evaluated. RESULTS: In patients, prior evaluation by CE-CT revealed 11 low- and 5 mid-grade stenoses of the CA and/or SMA. PV and AV were significantly higher in patients than in healthy volunteers [PV: p < 0.0001; AV: p = 0.03, p < 0.001]. PF and SV did not differ significantly between healthy volunteers and patients; however, a trend towards lower PF and SV could be detected in patients with mid-grade stenoses. Comparison of 4D flow MRI with CE-CT revealed a strong positive correlation in estimated degree of stenosis (CA: r = 0.86, SMA: r = 0.98). Patients with mid-grade stenoses had a significantly higher average WSS magnitude (AWM) than healthy volunteers (p = 0.02). CONCLUSION: This feasibility study suggests that 4D flow MRI is a viable technique for the evaluation of complex flow characteristics in small vessels such as the CA and SMA. 4D flow MRI approves comparable to the morphologic assessment of complex vascular territories using CE-CT but, in addition, offers the functional evaluation of flow parameters that goes beyond the morphology.
PURPOSE: This study aims to assess the feasibility of 4D flow MRI measurements in complex vascular territories; namely, the celiac artery (CA) and superior mesenteric artery (SMA). MATERIALS AND METHODS: In this prospective study, 22 healthy volunteers and 10 patients were scanned at 3 T. Blood flow parameters were compared between healthy volunteers and patients with stenosis of the CA and/or SMA as a function of stenosis grade characterized by prior contrast-enhanced computed tomography (CE-CT). The 4D flow MRI acquisition covered the CA, SMA and adjusting parts of the abdominal aorta (AO). Measurements of velocity- (peak velocity [PV], average velocity [AV]) and volume-related parameters (peak flow [PF], stroke volume [SV]) were conducted. Further, stenosis grade and wall shear stress in the CA, SMA and AO were evaluated. RESULTS: In patients, prior evaluation by CE-CT revealed 11 low- and 5 mid-grade stenoses of the CA and/or SMA. PV and AV were significantly higher in patients than in healthy volunteers [PV: p < 0.0001; AV: p = 0.03, p < 0.001]. PF and SV did not differ significantly between healthy volunteers and patients; however, a trend towards lower PF and SV could be detected in patients with mid-grade stenoses. Comparison of 4D flow MRI with CE-CT revealed a strong positive correlation in estimated degree of stenosis (CA: r = 0.86, SMA: r = 0.98). Patients with mid-grade stenoses had a significantly higher average WSS magnitude (AWM) than healthy volunteers (p = 0.02). CONCLUSION: This feasibility study suggests that 4D flow MRI is a viable technique for the evaluation of complex flow characteristics in small vessels such as the CA and SMA. 4D flow MRI approves comparable to the morphologic assessment of complex vascular territories using CE-CT but, in addition, offers the functional evaluation of flow parameters that goes beyond the morphology.
Authors: Thekla H Oechtering; Grant S Roberts; Nikolaos Panagiotopoulos; Oliver Wieben; Alejandro Roldán-Alzate; Scott B Reeder Journal: Abdom Radiol (NY) Date: 2021-11-27