Evaluation of atrial septal defects with 4D flow MRI-multilevel and inter-reader reproducibility for quantification of shunt severity

Autor: Delphine Ingremeau, Albert Hsiao, Dominica Sucha, Jean-Francois Paul, Raluca G. Chelu, Michael Horowitz, Shreyas S. Vasanawala, Koen Nieman, Isabella Kardys
Přispěvatelé: Cardiology, Radiology & Nuclear Medicine, Epidemiology
Rok vydání: 2019
Předmět:
Male
Pulmonary Circulation
Multiple measurements
Cardiovascular
Heart Septal Defects
Atrial
030218 nuclear medicine & medical imaging
Imaging
0302 clinical medicine
Prospective Studies
Lung
Observer Variation
Radiological and Ultrasound Technology
Cardiac shunt
Stroke volume
Middle Aged
Magnetic Resonance Imaging
Nuclear Medicine & Medical Imaging
medicine.anatomical_structure
Heart Disease
Descending aorta
Cardiology
Atrial septal defect
Female
Shunt (electrical)
Blood Flow Velocity
Research Article
Artery
Adult
medicine.medical_specialty
Biophysics
Bioengineering
Atrial septal defects
03 medical and health sciences
Imaging
Three-Dimensional
Clinical Research
Internal medicine
medicine.artery
Ascending aorta
MD Multidisciplinary
medicine
Humans
Radiology
Nuclear Medicine and imaging
Retrospective Studies
4D flow MRI
business.industry
Atrial
Heart Septal Defects
Reproducibility of Results
Stroke Volume
Blood flow
Brain Disorders
Cardiac Imaging Techniques
Three-Dimensional
business
Zdroj: Magma (New York, N.Y.), vol 32, iss 2
Magnetic Resonance Materials in Physics Biology and Medicine, 32(2), 269-279. Springer-Verlag
Chelu, Raluca G; Horowitz, Michael; Sucha, Dominica; Kardys, Isabella; Ingremeau, Delphine; Vasanawala, Shreyas; et al.(2019). Evaluation of atrial septal defects with 4D flow MRI—multilevel and inter-reader reproducibility for quantification of shunt severity. Magnetic Resonance Materials in Physics, Biology and Medicine. doi: 10.1007/s10334-018-0702-z. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/7mw5x1kd
Magma (New York, N.y.)
ISSN: 0968-5243
DOI: 10.1007/s10334-018-0702-z.
Popis: Purpose With the hypothesis that 4D flow can be used in evaluation of cardiac shunts, we seek to evaluate the multilevel and interreader reproducibility of measurements of the blood flow, shunt fraction and shunt volume in patients with atrial septum defect (ASD) in practice at multiple clinical sites. Materials and methods Four-dimensional flow MRI examinations were performed at four institutions across Europe and the US. Twenty-nine patients (mean age, 43 years; 11 male) were included in the study. Flow measurements were performed at three levels (valve, main artery and periphery) in both the pulmonary and systemic circulation by two independent readers and compared against stroke volumes from 4D flow anatomic data. Further, the shunt ratio (Qp/Qs) was calculated. Additionally, shunt volume was quantified at the atrial level by tracking the atrial septum. Results Measurements of the pulmonary blood flow at multiple levels correlate well whether measuring at the valve, main pulmonary artery or branch pulmonary arteries (r = 0.885–0.886). Measurements of the systemic blood flow show excellent correlation, whether measuring at the valve, ascending aorta or sum of flow from the superior vena cava (SVC) and descending aorta (r = 0.974–0.991). Intraclass agreement between the two observers for the flow measurements varies between 0.96 and 0.99. Compared with stroke volume, pulmonic flow is underestimated with 0.26 l/min at the main pulmonary artery level, and systemic flow is overestimated with 0.16 l/min at the ascending aorta level. Direct measurements of ASD flow are feasible in 20 of 29 (69%) patients. Conclusion Blood flow and shunt quantification measured at multiple levels and performed by different readers are reproducible and consistent with 4D flow MRI. Electronic supplementary material The online version of this article (10.1007/s10334-018-0702-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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