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Final ID: Paper #: 040

4D flow MRI of the Whole Heart in 4 Minutes with Compressed-SENSE: Feasibility for Quantification of Pathological Flow in Pediatric Congenital Heart Disease

Purpose or Case Report: 4D flow MRI with full coverage of the heart and proximal vessels is a powerful tool to understand hemodynamic pathology arising from congenital heart disease (CHD) and subsequent surgery; however, scan times often exceed 10 minutes thereby limiting widespread adoption in pediatrics. Decreasing scan time using compressed-SENSE (CS), a combination of conventional parallel imaging (SENSE) and randomized spatial undersampling, shows promise over SENSE alone. However, both the feasibility and its effect on accurate flow quantification in pediatrics has not been evaluated. This study investigated the feasibility of CS for pediatric 4D flow MRI to quantify flow indices used in risk stratification of CHD such as coarctation or pulmonary regurgitation, in comparison with SENSE.
Methods & Materials: 15 patients (15.0±7.3y) with CHD were enrolled. All patients’ images were acquired on a Philips Ingenia 3T with CS=6 and separately with SENSE= 2 (phase encode) x 2 (slice), with online reconstruction. Images were processed to remove noise and velocity aliasing. To quantify blood flow, 4 anatomical landmarks were defined for the aorta and 3 were defined for the pulmonary arteries. Peak velocity, systolic flow rate, and net flow rate were computed at each landmark. In addition, based on this data, Qp/Qs was derived. For patients with pulmonary regurgitation or aortic coarctation, regurgitant fraction and maximum peak velocity at the coarctation were quantified. A two-tailed, paired t-test was used for statistical analysis.
Results: Of 15 patients, 3 patients had hemi-Fontan circulation or uncorrectable severe aliasing in their images and pulmonary measurements were not included. 2 patients had coarctation and 3 patients had pulmonary regurgitation. CS achieved a reduction in scan time of 30.2% over the SENSE approach (3:47±1:07mins vs. 5:25±1:32mins, respectively). No statistical differences were found for peak velocity, peak flow rate, and net flow (p > 0.08 for all measurements). Qp/Qs showed no statistical differences (p=0.14) with mean values of 1.12±0.24 (CS) and 1.05±0.24 (SENSE). Coarctation velocities were equivalent with a mean difference of 5.6% (subject 1: 1.56m/s vs. 1.48m/s; subject 2: 2.60m/s vs. 2.46m/s; CS vs. SENSE). Regurgitant fraction had a mean difference of 1.9% (23.3±4.6% vs. 21.4±8.1% CS vs. SENSE).
Conclusions: CS 4D flow can measure whole heart pediatric hemodynamics in less than 4 minutes, suggesting CS can be implemented for pediatric patients in a clinically relevant time window.
  • Fujiwara, Takashi  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
  • Browne, Lorna  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
  • Malone, Ladonna  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
  • Lu, Quin  ( Philips Healthcare , San Francisco , California , United States )
  • Fonseca, Brian  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
  • Dimaria, Michael  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
  • Barker, Alex  ( Children's Hospital Colorado, University of Colorado Anschutz Medical Campus , Aurora , Colorado , United States )
Session Info:

Scientific Session II-B: Cardiovascular

Cardiovascular

SPR Scientific Papers

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Fetal Cardiac Magnetic Resonance Imaging (CMR) (FCMR) Correlation with Prenatal (echo) and Postnatal Imaging

Bardo Dianna, Lindblade Christopher, Wishah Fidaa, Patel Mittun, Cornejo Patricia, Ellsworth Erik, Awerbach Jordan, Goncalves Luis

3D Cardiac Models Aid in Surgical Planning for Complex Congenital Heart Disease in Infants

Schoeneberg Laura, Bornemeier Renee, Reemtsen Brian, Greiten Lawrence, Greenberg S Bruce, Lyons Karen, Renno Markus

More abstracts from these authors:
Use of Compressed Sensing to Reduce Scan Time and Breath-holding for Cine bSSFP in Pediatric Cardiac MRI

Naresh Nivedita, Browne Lorna, Barker Alex, Malone Ladonna, Fujiwara Takashi, Hulseberg-dwyer Emma, Mcgee Janet, Lu Quin, Twite Mark, Dimaria Michael, Fonseca Brian

The Proximal Pulmonary Arteries in Infants with Shunt Dependent Pulmonary Blood Flow: How Do Computed Tomography and Transthoracic Echocardiography Compare?

Ehrmann Daniel, Browne Lorna, Fonseca Brian, Younoszai Adel, Dimaria Michael

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