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Clinical evaluation of aortic coarctation with 4D flow MR imaging
Author(s) -
Hope Michael D.,
Meadows Alison K.,
Hope Thomas A.,
Ordovas Karen G.,
Saloner David,
Reddy Gautham P.,
Alley Marcus T.,
Higgins Charles B.
Publication year - 2010
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22083
Subject(s) - blood flow , medicine , coarctation of the aorta , descending aorta , hemodynamics , magnetic resonance imaging , cardiology , thoracic aorta , aorta , aortic arch , radiology , collateral circulation
Purpose: To show that 4D Flow is a clinically viable tool for evaluation of collateral blood flow and demonstration of distorted blood flow patterns in patients with treated and untreated aortic coarctation. Materials and Methods: Time‐resolved, 3D phase contrast magnetic resonance imaging (MRI) (4D Flow) was used to assess blood flow in the thoracic aorta of 34 individuals: 26 patients with coarctation (22 after surgery or stent placement) and eight healthy volunteers. Results: Direct comparison of blood flow calculated with 2D and 4D phase contrast data at standard levels for analysis in coarctation patients showed good correlation and agreement (correlation coefficient r = 0.99, limits of agreement = −20% to 20% for collateral blood flow calculations). Abnormal blood flow patterns were demonstrated at peak systole with 4D Flow visualization techniques in the descending thoracic aorta of patients but not volunteers. Marked helical flow was seen in 9 of 13 patients with angulated aortic arch geometries after coarctation repair. Vortical flow was seen in regions of poststenotic dilation. Conclusion: 4D Flow is a fast and reliable means of evaluating collateral blood flow in patients with aortic coarctation in order to establish hemodynamic significance. It also can detect distorted blood flow patterns in the descending aorta after coarctation repair. J. Magn. Reson. Imaging 2010;31:711–718. © 2010 Wiley‐Liss, Inc.