Ramaekers Mitch J F G, Te Kiefte Bastiaan J C, Adriaans Bouke P, Juffermans Joe F, van Assen Hans C, Winkens Bjorn, Wildberger Joachim E, Lamb Hildo J, Schalla Simon, Westenberg Jos J M
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center + (MUMC+), Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center + (MUMC+), Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Department of Radiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
J Cardiovasc Magn Reson. 2024;26(2):101083. doi: 10.1016/j.jocmr.2024.101083. Epub 2024 Aug 13.
Aortic blood flow characterization by four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) is increasingly performed in aneurysm research. A limited number of studies have established normal values that can aid the recognition of abnormal flow at an early stage. This study aims to establish additional sex-specific and age-dependent reference values for flow-related parameters in a large cohort of healthy adults.
Two hundred and twelve volunteers were included, and 191 volunteers completed the full study protocol. All underwent 4D flow CMR of the entire aorta. Quantitative values for velocity, vorticity, helicity, as well as total, circumferential, and axial wall shear stress (WSS) were determined for the aortic root (AoR), ascending aorta (AAo), aortic arch, descending aorta (DAo), suprarenal aorta, and infrarenal aorta. Vorticity and helicity were indexed for segment volume (mL).
The normal values were estimated per sex and age group, where significant differences between males (M) and females (F) were found only for specific age groups. More specifically, the following variables were significantly different after applying the false discovery rate correction for multiple testing: 1) velocity in the AAo and DAo in the 60-70 years age group (mean ± SD: (M) 47.0 ± 8.2 cm s vs (F) 38.4 ± 6.9 cm s, p = 0.001 and, (M) 55.9 ± 9.9 cm s vs (F) 46.5 ± 5.5 cm s, p = 0.002), 2) normalized vorticity in AoR in the 50-59 years age group ((M) 27,539 ± 5042 s mL vs (F) 30,849 ± 7285 s mL, p = 0.002), 3) axial WSS in the Aao in the 18-29 age group ((M) 1098 ± 203 mPa vs (F) 921 ± 121 mPa, p = 0.002). Good to strong negative correlations with age were seen for almost all variables, in different segments, and for both sexes.
This study describes reference values for aortic flow-related parameters acquired by 4D flow MRI. We observed limited differences between males and females. A negative relationship with age was seen for almost all flow-related parameters and segments.
在动脉瘤研究中，越来越多地采用四维（4D）血流心血管磁共振成像（CMR）来表征主动脉血流。少数研究已确定了正常数值，有助于早期识别异常血流。本研究旨在为一大群健康成年人的血流相关参数建立更多基于性别和年龄的参考值。
纳入212名志愿者，191名志愿者完成了完整的研究方案。所有人均接受了全主动脉的4D血流CMR检查。测定了主动脉根部（AoR）、升主动脉（AAo）、主动脉弓、降主动脉（DAo）、肾上腺上主动脉和肾上腺下主动脉的速度、涡度、螺旋度以及总壁面切应力、周向壁面切应力和轴向壁面切应力（WSS）的定量值。涡度和螺旋度以节段容积（mL）为指标。
按性别和年龄组估计正常数值，仅在特定年龄组发现男性（M）和女性（F）之间存在显著差异。更具体地说，在对多重检验应用错误发现率校正后，以下变量存在显著差异：1）60 - 70岁年龄组AAo和DAo中的速度（均值±标准差：（M）47.0±8.2 cm/s vs（F）38.4±6.9 cm/s，p = 0.001；以及（M）55.9±9.9 cm/s vs（F）46.5±5.5 cm/s，p = 0.002），2）50 - 59岁年龄组AoR中的标准化涡度（（M）27,539±5042 s/mL vs（F）30,849±7285 s/mL，p = 0.002），3）18 - 29岁年龄组Aao中的轴向WSS（（M）1098±203 mPa vs（F）921±121 mPa，p = 0.002）。几乎所有变量在不同节段以及男女两性中均与年龄呈现良好至强的负相关。
本研究描述了通过4D血流MRI获取的主动脉血流相关参数的参考值。我们观察到男性和女性之间的差异有限。几乎所有血流相关参数和节段均与年龄呈负相关。
