Bollache, E; Knott, KD; Jarvis, K; Boubertakh, R; Dolan, RS; Camaioni, C; Collins, L; ... Markl, M; + view all Bollache, E; Knott, KD; Jarvis, K; Boubertakh, R; Dolan, RS; Camaioni, C; Collins, L; Scully, P; Rabin, S; Treibel, T; Carr, JC; van Ooij, P; Collins, JD; Geiger, J; Moon, JC; Barker, AJ; Petersen, SE; Markl, M; - view fewer (2019) Two-Minute k-Space and Time–accelerated Aortic Four-dimensional Flow MRI: Dual-Center Study of Feasibility and Impact on Velocity and Wall Shear Stress Quantification. Radiology: Cardiothoracic Imaging , 1 (2) , Article e180008. 10.1148/ryct.2019180008.

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Abstract

PURPOSE: To investigate the two-center feasibility of highly k-space and time (k-t)–accelerated 2-minute aortic four-dimensional (4D) flow MRI and to evaluate its performance for the quantification of velocities and wall shear stress (WSS). MATERIALS AND METHODS: This cross-sectional study prospectively included 68 participants (center 1, 11 healthy volunteers [mean age ± standard deviation, 61 years ± 15] and 16 patients with aortic disease [mean age, 60 years ± 10]; center 2, 14 healthy volunteers [mean age, 38 years ± 13] and 27 patients with aortic or cardiac disease [mean age, 78 years ± 18]). Each participant underwent highly accelerated 4D flow MRI (k-t acceleration, acceleration factor of 5) of the thoracic aorta. For comparison, conventional 4D flow MRI (acceleration factor of 2) was acquired in the participants at center 1 (n = 27). Regional aortic peak systolic velocities and three-dimensional WSS were quantified. RESULTS: k-t–accelerated scan times (center 1, 2:03 minutes ± 0:29; center 2, 2:06 minutes ± 0:20) were significantly reduced compared with conventional 4D flow MRI (center 1, 12:38 minutes ± 2:25; P < .0001). Overall good agreement was found between the two techniques (absolute differences ≤15%), but proximal aortic WSS was significantly underestimated in patients by using k-t–accelerated 4D flow when compared with conventional 4D flow (P ≤ .03). k-t–accelerated 4D flow MRI was reproducible (intra- and interobserver intraclass correlation coefficient ≥0.98) and identified significantly increased peak velocities and WSS in patients with stenotic (P ≤ .003) or bicuspid (P ≤ .04) aortic valves compared with healthy volunteers. In addition, k-t–accelerated 4D flow MRI–derived velocities and WSS were inversely related to age (r ≥−0.53; P ≤ .03) over all healthy volunteers. CONCLUSION: k-t–accelerated aortic 4D flow MRI providing 2-minute scan times was feasible and reproducible at two centers. Although consistent healthy aging- and disease-related changes in aortic hemodynamics were observed, care should be taken when considering WSS, which can be underestimated in patients.

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