Evaluation of Real-Time Cardiovascular Flow MRI Using Compressed Sensing in a Phantom and in Patients With Valvular Disease or Arrhythmia
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| Title: | Evaluation of Real-Time Cardiovascular Flow MRI Using Compressed Sensing in a Phantom and in Patients With Valvular Disease or Arrhythmia |
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| Authors: | Lala, Tania, Christierson, Lea, Frieberg, Petter, Giese, Daniel, Kellman, Peter, Hakacova, Nina, Sjöberg, Pia, Ostenfeld, Ellen, Töger, Johannes |
| Contributors: | Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Clinical Physiology (Lund), Lund Cardiac MR Group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Klinisk fysiologi, Lund, Hjärt-MR-gruppen i Lund, Originator, Lund University, Faculty of Engineering, LTH, LTH Profile areas, LTH Profile Area: Engineering Health, Lunds universitet, Lunds Tekniska Högskola, LTH profilområden, LTH profilområde: Teknik för hälsa, Originator, Lund University, Faculty of Engineering, LTH, Departments at LTH, Department of Biomedical Engineering, Division for Biomedical Engineering, Lunds universitet, Lunds Tekniska Högskola, Institutioner vid LTH, Institutionen för biomedicinsk teknik, Avdelningen för biomedicinsk teknik, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), eSSENCE: The e-Science Collaboration, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), eSSENCE: The e-Science Collaboration, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section V, Paediatrics (Lund), Children cardiology, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion V, Pediatrik, Lund, Barnkardiologi, Originator, Lund University, Faculty of Science, Medical Radiation Physics, Lund, MR Physics, Lunds universitet, Naturvetenskapliga fakulteten, Medicinsk strålningsfysik, Lund, MR Physics, Originator |
| Source: | Journal of Magnetic Resonance Imaging. 62(2):417-429 |
| Subject Terms: | Engineering and Technology, Medical Engineering, Medical Imaging, Teknik, Medicinteknik, Medicinsk bildvetenskap, Medical and Health Sciences, Clinical Medicine, Radiology and Medical Imaging, Medicin och hälsovetenskap, Klinisk medicin, Radiologi och bildbehandling, Cardiology and Cardiovascular Disease, Kardiologi och kardiovaskulära sjukdomar |
| Description: | Background: Real-time (RT) phase contrast (PC) flow MRI can potentially be used to measure blood flow in arrhythmic patients. Undersampled RT PC has been combined with online compressed sensing (CS) reconstruction (CS RT) enabling clinical use. However, CS RT flow has not been validated in a clinical setting. Purpose: Evaluate CS RT in phantom and patients. Study Type: Prospective. Population: Flow phantom (60 cycles/min: N = 10, 120 cycles/min: N = 12), sinus rhythm patients, no regurgitation (N = 20) or suspected aortic regurgitation (N = 10), arrhythmia patients (N = 10). Field Strength/Sequence: 1.5 T, 2D gated PC, CS RT PC, RT cine with arrhythmia rejection. Assessment: Phantom experiments tested the accuracy of CS RT cardiac output and peak flow rate at 60 and 120 cycles/min against gated PC. For sinus rhythm patients, cardiac output, peak flow rate, and regurgitation fraction in the ascending aorta and/or pulmonary artery were evaluated against gated PC. Cardiac output in patients with arrythmia was evaluated against RT cine with arrhythmia rejection. Statistical Tests: Bland Altman, correlation, Mann–Whitney test, Wilcoxon signed-rank test. Results: Cardiac output bias ± SD for CS RT in the phantom was −0.0 ± 0.2 L/min (0.5 ± 3%, P = 0.76) at 60 cycles/min and 0.2 ± 0.3 L/min (4 ± 4%, P = 0.0016) at 120 cycles/min. Correspondingly, peak flow rate bias was −23 ± 6 mL/s (−7 ± 2%, P < 0.0001) and −73 ± 25 mL/s (−23 ± 4%, P < 0.0001). In patients, regurgitant fraction was −4 ± 0.5% (−23 ± 4%, P = 0.0025). Cardiac output bias in patients in sinus rhythm was −0.1 ± 0.5 L/min (−2 ± 10%, P = 0.99) (with regurgitation) and −0.3 ± 0.6 L/min (−5 ± 11%, P = 0.035) (without regurgitation). Peak flow rate bias was −60 ± 31 mL/s (−13 ± 6%, P < 0.0001) (with regurgitation) and −64 ± 32 mL/s (−16 ± 8%, P < 0.0001) (without regurgitation). Cardiac output bias was −0.4 ± 0.6 L/min (−9 ± 11%, P < 0.003) in arrhythmia patients. Data Conclusions: CS RT flow could potentially serve as a clinical tool for patients with or without valvular disease or arrhythmia, with accurate cardiac output and regurgitation fraction quantification. Plain Language Summary: Accurate flow assessment is important in clinical evaluation of cardiac patients, but in the presence of irregular heart rhythm flow assessment is challenging. We have evaluated a new method using cardiac magnetic resonance imaging and real-time flow for blood flow assessment in cardiac patients. The method was tested against a reference method in a phantom flow model in low and high heart rates, and in cardiac patients with and without irregular heart rhythm and in different vessels. We found the cardiac magnetic resonance imaging real time flow method accurate and therefore promising for clinical implementation. Evidence Level: 1. Technical Efficacy: Stage 1. |
| Access URL: | https://doi.org/10.1002/jmri.29702 |
| Database: | SwePub |
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