5D 流动磁共振成像：一种用于心脏和呼吸运动分辨三维血流动力学的完全自门控、自由运行框架。
5D Flow MRI: A Fully Self-gated, Free-running Framework for Cardiac and Respiratory Motion-resolved 3D Hemodynamics.
作者信息
Ma Liliana E, Yerly Jérôme, Piccini Davide, Di Sopra Lorenzo, Roy Christopher W, Carr James C, Rigsby Cynthia K, Kim Daniel, Stuber Matthias, Markl Michael
机构信息
Departments of Radiology, Feinberg School of Medicine (L.E.M., J.C.C., C.K.R., D.K., M.M.) and Biomedical Engineering (L.E.M., J.C.C., D.K., M.M.), Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (J.Y., D.P., L.D.S., C.W.R., M.S.); Center for Biomedical Imaging, Lausanne, Switzerland (J.Y., M.S.); Department of Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland (D.P.); and Department of Medical Imaging, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill (C.K.R.).
出版信息
Radiol Cardiothorac Imaging. 2020 Nov 12;2(6):e200219. doi: 10.1148/ryct.2020200219. eCollection 2020 Nov.
PURPOSE
To implement, validate, and apply a self-gated free-running whole-heart five-dimensional (5D) flow MRI framework to evaluate respiration-driven effects on three-dimensional (3D) hemodynamics in a clinical setting.
MATERIALS AND METHODS
In this prospective study, a free-running five-dimensional (5D) flow sequence was implemented with 3D radial sampling, self-gating, and a compressed-sensing reconstruction. The 5D flow was evaluated in a pulsatile phantom and adult participants with aortic and/or valvular disease who were enrolled between May and August 2019. Conventional twofold-accelerated four-dimensional (4D) flow of the thoracic aorta with navigator gating was performed as a reference comparison. Continuous parameters were evaluated for parameter normality and were compared between conventional 4D flow and 5D flow using a signed-rank or two-tailed paired test. Differences between respiratory states were evaluated using a repeated-measure analysis of variance or a nonparametric Friedman test.
RESULTS
A total of 20 adult participants (mean age, 49 years ± 17 [standard deviation]; 18 men and two women) were included. In vitro 5D flow results showed excellent agreement with conventional 4D flow-derived values (peak and net flow, <7% difference over all quantified planes). Whole-heart 5D flow data were collected in all participants in 7.65 minutes ± 0.35 (acceleration rate = 36.0-76.9) versus 9.88 minutes ± 3.17 for conventional aortic 4D flow. In vivo, 5D flow demonstrated moderate agreement with conventional 4D flow but demonstrated overestimation in net flow and peak velocity (up to 26% and 12%, respectively) in the ascending aorta and underestimation (<12%) in the arch and descending aorta. Respiratory-resolved analyses of caval veins showed significantly increased net and peak flow in the inferior vena cava in end inspiration compared with end expiration, and the opposite trend was shown in the superior vena cava.
CONCLUSION
A free-running 5D flow MRI framework consistently captured cardiac and respiratory motion-resolved 3D hemodynamics in less than 8 minutes. © RSNA, 2020.
目的
实施、验证并应用一种自门控自由运行的全心五维（5D）血流磁共振成像（MRI）框架，以在临床环境中评估呼吸对三维（3D）血流动力学的驱动作用。
材料与方法
在这项前瞻性研究中，采用3D径向采样、自门控和压缩感知重建技术实施了一种自由运行的五维（5D）血流序列。对一个搏动性体模以及2019年5月至8月期间招募的患有主动脉和/或瓣膜疾病的成年参与者进行了5D血流评估。将采用导航门控的传统两倍加速的胸主动脉四维（4D）血流检查作为参考对照。对连续参数进行参数正态性评估，并使用符号秩检验或双尾配对检验对传统4D血流和5D血流之间的参数进行比较。使用重复测量方差分析或非参数弗里德曼检验评估呼吸状态之间的差异。
结果
共纳入20名成年参与者（平均年龄49岁±17[标准差]；18名男性和2名女性）。体外5D血流结果与传统4D血流得出的值具有良好的一致性（峰值和净流量，在所有量化平面上差异<7%）。所有参与者的全心5D血流数据采集时间为7.65分钟±0.35（加速率=36.0 - 76.9），而传统主动脉四维血流的采集时间为9.88分钟±3.17。在体内，5D血流与传统4D血流显示出中等程度的一致性，但在升主动脉中净流量和峰值速度出现高估（分别高达26%和12%），而在主动脉弓和降主动脉中出现低估（<12%）。对腔静脉进行呼吸分辨分析显示，与呼气末相比，吸气末下腔静脉的净流量和峰值流量显著增加，而上腔静脉则呈现相反趋势。
结论
一种自由运行的5D血流MRI框架能够在不到8分钟的时间内持续捕捉心脏和呼吸运动分辨的3D血流动力学。©RSNA，2020。
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