Liliana E Ma1,2, Michael Markl1,2, Kelvin Chow1,3, Hyungkyu Huh4, Christoph Forman5, Alireza Vali1, Andreas Greiser5, James Carr1, Susanne Schnell1, Alex J Barker6,7, Ning Jin8. 1. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 2. Department of Biomedical Engineering, Northwestern University, Chicago, Illinois. 3. Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc, Chicago, Illinois. 4. Daegu-Gyeongbuk Medical Innovation Foundation, Medical Device Development Center, Daegu, South Korea. 5. Siemens Healthcare, Erlangen, Germany. 6. Department of Radiology, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Denver, Colorado. 7. Department of Bioengineering, University of Colorado, Anschutz Medical Campus, Denver, Colorado. 8. Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc, Cleveland, Ohio.
Abstract
PURPOSE: To evaluate the accuracy and feasibility of a free-breathing 4D flow technique using compressed sensing (CS), where 4D flow imaging of the thoracic aorta is performed in 2 min with inline image reconstruction on the MRI scanner in less than 5 min. METHODS: The 10 in vitro 4D flow MRI scans were performed with different acceleration rates on a pulsatile flow phantom (9 CS acceleration factors [R = 5.4-14.1], 1 generalized autocalibrating partially parallel acquisition [GRAPPA] R = 2). Based on in vitro results, CS-accelerated 4D flow of the thoracic aorta was acquired in 20 healthy volunteers (38.3 ± 15.2 years old) and 11 patients with aortic disease (61.3 ± 15.1 years) with R = 7.7. A conventional 4D flow scan was acquired with matched spatial coverage and temporal resolution. RESULTS: CS depicted similar hemodynamics to conventional 4D flow in vitro, and in vivo, with >70% reduction in scan time (volunteers: 1:52 ± 0:25 versus 7:25 ± 2:35 min). Net flow values were within 3.5% in healthy volunteers, and voxel-by-voxel comparison demonstrated good agreement. CS significantly underestimated peak velocities (vmax ) and peak flow (Qmax ) in both volunteers and patients (volunteers: vmax , -16.2% to -9.4%, Qmax : -11.6% to -2.9%, patients: vmax , -11.2% to -4.0%; Qmax , -10.2% to -5.8%). CONCLUSION: Aortic 4D flow with CS is feasible in a two minute scan with less than 5 min for inline reconstruction. While net flow agreement was excellent, CS with R = 7.7 produced underestimation of Qmax and vmax ; however, these were generally within 13% of conventional 4D flow-derived values. This approach allows 4D flow to be feasible in clinical practice for comprehensive assessment of hemodynamics.
PURPOSE: To evaluate the accuracy and feasibility of a free-breathing 4D flow technique using compressed sensing (CS), where 4D flow imaging of the thoracic aorta is performed in 2 min with inline image reconstruction on the MRI scanner in less than 5 min. METHODS: The 10 in vitro 4D flow MRI scans were performed with different acceleration rates on a pulsatile flow phantom (9 CS acceleration factors [R = 5.4-14.1], 1 generalized autocalibrating partially parallel acquisition [GRAPPA] R = 2). Based on in vitro results, CS-accelerated 4D flow of the thoracic aorta was acquired in 20 healthy volunteers (38.3 ± 15.2 years old) and 11 patients with aortic disease (61.3 ± 15.1 years) with R = 7.7. A conventional 4D flow scan was acquired with matched spatial coverage and temporal resolution. RESULTS:CS depicted similar hemodynamics to conventional 4D flow in vitro, and in vivo, with >70% reduction in scan time (volunteers: 1:52 ± 0:25 versus 7:25 ± 2:35 min). Net flow values were within 3.5% in healthy volunteers, and voxel-by-voxel comparison demonstrated good agreement. CS significantly underestimated peak velocities (vmax ) and peak flow (Qmax ) in both volunteers and patients (volunteers: vmax , -16.2% to -9.4%, Qmax : -11.6% to -2.9%, patients: vmax , -11.2% to -4.0%; Qmax , -10.2% to -5.8%). CONCLUSION: Aortic 4D flow with CS is feasible in a two minute scan with less than 5 min for inline reconstruction. While net flow agreement was excellent, CS with R = 7.7 produced underestimation of Qmax and vmax ; however, these were generally within 13% of conventional 4D flow-derived values. This approach allows 4D flow to be feasible in clinical practice for comprehensive assessment of hemodynamics.
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