Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, 13353, Berlin, Germany.
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Int J Cardiovasc Imaging. 2024 Jul;40(7):1511-1524. doi: 10.1007/s10554-024-03132-9. Epub 2024 May 31.
4D-flow MRI is a promising technique for assessing vessel hemodynamics. However, its utilization is currently limited by the lack of reference values, particularly for pulmonary vessels. In this work, we have analysed flow and velocity in the pulmonary trunk (PT), left and right pulmonary arteries (LPA and RPA, respectively) in Landrace pigs at both rest and stress through the software MEVISFlow. Nine healthy Landrace pigs were acutely instrumented closed-chest and transported to the CMR facility for evaluation. After rest measurements, dobutamine was administered to achieve a 25% increase in heart rate compared to rest. 4D-flow MRI images have been analysed through MEVISFlow by two independent observers. Inter- and intra-observer reproducibility was quantified using intraclass correlation coefficient. A significant difference between rest and stress regarding flow and velocity in all the pulmonary vessels was observed. Mean flow increased 55% in PT, 75% in LPA and 40% in RPA. Mean peak velocity increased 55% in PT, 75% in LPA and 66% in RPA. A good-to-excellent reproducibility was observed in rest and stress for flow measurements in all three arteries. An excellent reproducibility for velocity was found in PT at rest and stress, a good one for LPA and RPA at rest, while poor reproducibility was found at stress. The current study showed that pulmonary flow and velocity assessed through 4D-flow MRI follow the physiological alterations during cardiac cycle and after stress induced by dobutamine. A clinical translation to assess pulmonary diseases with 4D-flow MRI under stress conditions needs investigation.
4D-flow MRI 是一种有前途的评估血管血液动力学的技术。然而，其应用目前受到参考值缺乏的限制，尤其是在肺血管方面。在这项工作中，我们使用 MEVISFlow 软件分析了休息和应激状态下长白猪的肺动脉干（PT）、左肺动脉（LPA）和右肺动脉（RPA）中的血流和速度。9 头健康的长白猪在闭胸状态下进行了急性仪器植入，并被运送到 CMR 设施进行评估。在休息测量后，给予多巴酚丁胺以达到与休息时相比心率增加 25%。通过 MEVISFlow 对 4D-flow MRI 图像进行了分析，由两名独立观察者进行分析。使用组内相关系数来量化观察者间和观察者内的可重复性。在所有肺血管中，休息和应激状态下的流量和速度均观察到显著差异。PT 的平均流量增加了 55%，LPA 增加了 75%，RPA 增加了 40%。PT 的平均峰值速度增加了 55%，LPA 增加了 75%，RPA 增加了 66%。在休息和应激状态下，所有三条动脉的流量测量均具有良好至极好的可重复性。在休息和应激状态下，PT 的速度具有极好的可重复性，LPA 和 RPA 的可重复性良好，而在应激状态下，可重复性较差。本研究表明，通过 4D-flow MRI 评估的肺血流和速度在心动周期期间以及多巴酚丁胺诱导的应激后遵循生理变化。需要研究在应激条件下使用 4D-flow MRI 评估肺部疾病的临床转化。
