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Erschienen in: European Radiology 5/2012

01.05.2012 | Magnetic Resonance

Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla

verfasst von: Alex Frydrychowicz, Alexander Berger, Alejandro Munoz del Rio, Maximilian F. Russe, Jelena Bock, Andreas Harloff, Michael Markl

Erschienen in: European Radiology | Ausgabe 5/2012

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Abstract

Objective

It was the aim to analyse the impact of age, aortic arch geometry, and size on secondary flow patterns such as helix and vortex flow derived from flow-sensitive magnetic resonance imaging (4D PC-MRI).

Methods

62 subjects (age range = 20–80 years) without circumscribed pathologies of the thoracic aorta (ascending aortic (AAo) diameter: 3.2 ± 0.6 cm [range 2.2–5.1]) were examined by 4D PC-MRI after IRB-approval and written informed consent. Blood flow visualisation based on streamlines and time-resolved 3D particle traces was performed. Aortic diameter, shape (gothic, crook-shaped, cubic), angle, and age were correlated with existence and extent of secondary flow patterns (helicity, vortices); statistical modelling was performed.

Results

Helical flow was the typical pattern in standard crook-shaped aortic arches. With altered shapes and increasing age, helicity was less common. AAo diameter and age had the highest correlation (r = 0.69 and 0.68, respectively) with number of detected vortices. None of the other arch geometric or demographic variables (for all, P ≥ 0.177) improved statistical modelling.

Conclusion

Substantially different secondary flow patterns can be observed in the normal thoracic aorta. Age and the AAo diameter were the parameters correlating best with presence and amount of vortices. Findings underline the importance of age- and geometry-matched control groups for haemodynamic studies.

Key Points

Secondary blood flow patterns (helices, vortices) are commonly observed in the aorta
Secondary flow patterns predominantly depend on patient age and aortic diameter
Geometric factors show a lesser impact on blood flow patterns than age and diameter
Future analyses of flow patterns should incorporate age- and diameter dependencies
Literatur
1.
Zurück zum Zitat Hager A, Kaemmerer H, Rapp-Bernhardt U et al (2002) Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg 123:1060–1066CrossRefPubMed Hager A, Kaemmerer H, Rapp-Bernhardt U et al (2002) Diameters of the thoracic aorta throughout life as measured with helical computed tomography. J Thorac Cardiovasc Surg 123:1060–1066CrossRefPubMed
2.
Zurück zum Zitat Itani Y, Watanabe S, Masuda Y et al (2002) Measurement of aortic diameters and detection of asymptomatic aortic aneurysms in a mass screening program using a mobile helical computed tomography unit. Hear Vessel 16:42–45CrossRef Itani Y, Watanabe S, Masuda Y et al (2002) Measurement of aortic diameters and detection of asymptomatic aortic aneurysms in a mass screening program using a mobile helical computed tomography unit. Hear Vessel 16:42–45CrossRef
3.
Zurück zum Zitat Mao SS, Ahmadi N, Shah B et al (2008) Normal thoracic aorta diameter on cardiac computed tomography in healthy asymptomatic adults: impact of age and gender. Acad Radiol 15:827–834CrossRefPubMed Mao SS, Ahmadi N, Shah B et al (2008) Normal thoracic aorta diameter on cardiac computed tomography in healthy asymptomatic adults: impact of age and gender. Acad Radiol 15:827–834CrossRefPubMed
4.
Zurück zum Zitat Malek AM, Alper SL, Izumo S (1999) Haemodynamic shear stress and its role in atherosclerosis. Jama 282:2035–2042CrossRefPubMed Malek AM, Alper SL, Izumo S (1999) Haemodynamic shear stress and its role in atherosclerosis. Jama 282:2035–2042CrossRefPubMed
5.
Zurück zum Zitat Davies PF (1995) Flow-mediated endothelial mechanotransduction. Physiol Rev 75:519–560PubMed Davies PF (1995) Flow-mediated endothelial mechanotransduction. Physiol Rev 75:519–560PubMed
6.
Zurück zum Zitat Langille BL, O’Donnell F (1986) Reductions in arterial diameter produced by chronic decreases in blood flow are endothelium-dependent. Science 231:405–407CrossRefPubMed Langille BL, O’Donnell F (1986) Reductions in arterial diameter produced by chronic decreases in blood flow are endothelium-dependent. Science 231:405–407CrossRefPubMed
7.
Zurück zum Zitat Steinman DA, Taylor CA (2005) Flow imaging and computing: large artery haemodynamics. Ann Biomed Eng 33:1704–1709CrossRefPubMed Steinman DA, Taylor CA (2005) Flow imaging and computing: large artery haemodynamics. Ann Biomed Eng 33:1704–1709CrossRefPubMed
8.
Zurück zum Zitat Moran PR (1982) A flow velocity zeugmatographic interlace for NMR imaging in humans. Magn Reson Imaging 1:197–203CrossRefPubMed Moran PR (1982) A flow velocity zeugmatographic interlace for NMR imaging in humans. Magn Reson Imaging 1:197–203CrossRefPubMed
9.
Zurück zum Zitat Bryant DJ, Payne JA, Firmin DN et al (1984) Measurement of flow with NMR imaging using a gradient pulse and phase difference technique. J Comput Assist Tomogr 8:588–593CrossRefPubMed Bryant DJ, Payne JA, Firmin DN et al (1984) Measurement of flow with NMR imaging using a gradient pulse and phase difference technique. J Comput Assist Tomogr 8:588–593CrossRefPubMed
10.
Zurück zum Zitat Wigstrom L, Sjoqvist L, Wranne B (1996) Temporally resolved 3D phase-contrast imaging. Magn Reson Med 36:800–803CrossRefPubMed Wigstrom L, Sjoqvist L, Wranne B (1996) Temporally resolved 3D phase-contrast imaging. Magn Reson Med 36:800–803CrossRefPubMed
11.
Zurück zum Zitat Bogren HG, Buonocore MH (1999) 4D magnetic resonance velocity mapping of blood flow patterns in the aorta in young vs. elderly normal subjects. J Magn Reson Imaging 10:861–869CrossRefPubMed Bogren HG, Buonocore MH (1999) 4D magnetic resonance velocity mapping of blood flow patterns in the aorta in young vs. elderly normal subjects. J Magn Reson Imaging 10:861–869CrossRefPubMed
12.
Zurück zum Zitat Bogren HG, Buonocore MH, Valente RJ (2004) Four-dimensional magnetic resonance velocity mapping of blood flow patterns in the aorta in patients with atherosclerotic coronary artery disease compared to age-matched normal subjects. J Magn Reson Imaging 19:417–427CrossRefPubMed Bogren HG, Buonocore MH, Valente RJ (2004) Four-dimensional magnetic resonance velocity mapping of blood flow patterns in the aorta in patients with atherosclerotic coronary artery disease compared to age-matched normal subjects. J Magn Reson Imaging 19:417–427CrossRefPubMed
13.
Zurück zum Zitat Kilner PJ, Yang GZ, Mohiaddin RH et al (1993) Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation 88:2235–2247PubMed Kilner PJ, Yang GZ, Mohiaddin RH et al (1993) Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation 88:2235–2247PubMed
14.
Zurück zum Zitat Markl M, Harloff A, Bley TA et al (2007) Time-resolved 3D MR velocity mapping at 3T: improved navigator-gated assessment of vascular anatomy and blood flow. J Magn Reson Imaging 25:824–831CrossRefPubMed Markl M, Harloff A, Bley TA et al (2007) Time-resolved 3D MR velocity mapping at 3T: improved navigator-gated assessment of vascular anatomy and blood flow. J Magn Reson Imaging 25:824–831CrossRefPubMed
15.
Zurück zum Zitat Walker PG, Cranney GB, Scheidegger MB et al (1993) Semiautomated method for noise reduction and background phase error correction in MR phase velocity data. J Magn Reson Imaging 3:521–530CrossRefPubMed Walker PG, Cranney GB, Scheidegger MB et al (1993) Semiautomated method for noise reduction and background phase error correction in MR phase velocity data. J Magn Reson Imaging 3:521–530CrossRefPubMed
16.
Zurück zum Zitat Frydrychowicz A, Markl M, Hirtler D et al (2011) Aortic haemodynamics in patients with and without repair of aortic coarctation: in vivo analysis by 4D flow-sensitive magnetic resonance imaging. Invest Radiol 46:317–325PubMed Frydrychowicz A, Markl M, Hirtler D et al (2011) Aortic haemodynamics in patients with and without repair of aortic coarctation: in vivo analysis by 4D flow-sensitive magnetic resonance imaging. Invest Radiol 46:317–325PubMed
17.
Zurück zum Zitat Bogaert J, Gewillig M, Rademakers F et al (1995) Transverse arch hypoplasia predisposes to aneurysm formation at the repair site after patch angioplasty for coarctation of the aorta. J Am Coll Cardiol 26:521–527CrossRefPubMed Bogaert J, Gewillig M, Rademakers F et al (1995) Transverse arch hypoplasia predisposes to aneurysm formation at the repair site after patch angioplasty for coarctation of the aorta. J Am Coll Cardiol 26:521–527CrossRefPubMed
18.
Zurück zum Zitat Ou P, Celermajer DS, Mousseaux E et al (2007) Vascular remodeling after “successful” repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol 49:883–890CrossRefPubMed Ou P, Celermajer DS, Mousseaux E et al (2007) Vascular remodeling after “successful” repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol 49:883–890CrossRefPubMed
19.
Zurück zum Zitat Klipstein RH, Firmin DN, Underwood SR et al (1987) Blood flow patterns in the human aorta studied by magnetic resonance. Br Heart J 58:316–323CrossRefPubMed Klipstein RH, Firmin DN, Underwood SR et al (1987) Blood flow patterns in the human aorta studied by magnetic resonance. Br Heart J 58:316–323CrossRefPubMed
20.
Zurück zum Zitat Mohiaddin RH, Yang GZ, Kilner PJ et al (1994) Visualisation of flow by vector analysis of multidirectional cine MR velocity mapping. J Comput Assist Tomogr 18:383–392CrossRefPubMed Mohiaddin RH, Yang GZ, Kilner PJ et al (1994) Visualisation of flow by vector analysis of multidirectional cine MR velocity mapping. J Comput Assist Tomogr 18:383–392CrossRefPubMed
21.
Zurück zum Zitat Bogren HG, Mohiaddin RH, Kilner PJ et al (1997) Blood flow patterns in the thoracic aorta studied with three-directional MR velocity mapping: the effects of age and coronary artery disease. J Magn Reson Imaging 7:784–793CrossRefPubMed Bogren HG, Mohiaddin RH, Kilner PJ et al (1997) Blood flow patterns in the thoracic aorta studied with three-directional MR velocity mapping: the effects of age and coronary artery disease. J Magn Reson Imaging 7:784–793CrossRefPubMed
22.
Zurück zum Zitat Kvitting JP, Ebbers T, Wigstrom L et al (2004) Flow patterns in the aortic root and the aorta studied with time-resolved, 3-dimensional, phase-contrast magnetic resonance imaging: implications for aortic valve-sparing surgery. J Thorac Cardiovasc Surg 127:1602–1607CrossRefPubMed Kvitting JP, Ebbers T, Wigstrom L et al (2004) Flow patterns in the aortic root and the aorta studied with time-resolved, 3-dimensional, phase-contrast magnetic resonance imaging: implications for aortic valve-sparing surgery. J Thorac Cardiovasc Surg 127:1602–1607CrossRefPubMed
23.
Zurück zum Zitat Markl M, Draney MT, Hope MD et al (2004) Time-resolved 3-dimensional velocity mapping in the thoracic aorta: visualisation of 3-directional blood flow patterns in healthy volunteers and patients. J Comput Assist Tomogr 28:459–468CrossRefPubMed Markl M, Draney MT, Hope MD et al (2004) Time-resolved 3-dimensional velocity mapping in the thoracic aorta: visualisation of 3-directional blood flow patterns in healthy volunteers and patients. J Comput Assist Tomogr 28:459–468CrossRefPubMed
24.
Zurück zum Zitat Mohiaddin RH, Kilner PJ, Rees S, Longmore DB (1993) Magnetic resonance volume flow and jet velocity mapping in aortic coarctation. J Am Coll Cardiol 22:1515–1521CrossRefPubMed Mohiaddin RH, Kilner PJ, Rees S, Longmore DB (1993) Magnetic resonance volume flow and jet velocity mapping in aortic coarctation. J Am Coll Cardiol 22:1515–1521CrossRefPubMed
25.
Zurück zum Zitat Hope TA, Markl M, Wigstrom L, Alley MT, Miller DC, Herfkens RJ (2007) Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging 26:1471–1479CrossRefPubMed Hope TA, Markl M, Wigstrom L, Alley MT, Miller DC, Herfkens RJ (2007) Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging 26:1471–1479CrossRefPubMed
26.
Zurück zum Zitat Frydrychowicz A, Arnold R, Hirtler D et al (2008) Multidirectional flow analysis by cardiovascular magnetic resonance in aneurysm development following repair of aortic coarctation. J Cardiovasc Magn Reson 10:30CrossRefPubMed Frydrychowicz A, Arnold R, Hirtler D et al (2008) Multidirectional flow analysis by cardiovascular magnetic resonance in aneurysm development following repair of aortic coarctation. J Cardiovasc Magn Reson 10:30CrossRefPubMed
27.
Zurück zum Zitat Weigang E, Kari FA, Beyersdorf F et al (2008) Flow-sensitive four-dimensional magnetic resonance imaging: flow patterns in ascending aortic aneurysms. Eur J Cardiothorac Surg 34:11–16CrossRefPubMed Weigang E, Kari FA, Beyersdorf F et al (2008) Flow-sensitive four-dimensional magnetic resonance imaging: flow patterns in ascending aortic aneurysms. Eur J Cardiothorac Surg 34:11–16CrossRefPubMed
28.
Zurück zum Zitat Markl M, Arnold R, Hirtler D et al (2009) Three-dimensional flow characteristics in aortic coarctation and poststenotic dilatation. J Comput Assist Tomogr 33:776–778CrossRefPubMed Markl M, Arnold R, Hirtler D et al (2009) Three-dimensional flow characteristics in aortic coarctation and poststenotic dilatation. J Comput Assist Tomogr 33:776–778CrossRefPubMed
29.
Zurück zum Zitat Morbiducci U, Ponzini R, Rizzo G et al (2009) In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging. Ann Biomed Eng 37:516–531CrossRefPubMed Morbiducci U, Ponzini R, Rizzo G et al (2009) In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging. Ann Biomed Eng 37:516–531CrossRefPubMed
30.
Zurück zum Zitat Friman O, Hennemuth A, Harloff A, Bock J, Markl M, Peitgen H-O (2010) Probabilistic flow connectivity mapping. Proc Intl Soc Mag Reson Med 18:1334 Friman O, Hennemuth A, Harloff A, Bock J, Markl M, Peitgen H-O (2010) Probabilistic flow connectivity mapping. Proc Intl Soc Mag Reson Med 18:1334
Metadaten
Titel
Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla
verfasst von
Alex Frydrychowicz
Alexander Berger
Alejandro Munoz del Rio
Maximilian F. Russe
Jelena Bock
Andreas Harloff
Michael Markl
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 5/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2353-6

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