Evaluation of 3D blood flow patterns and wall shear stress in the normal and dilated thoracic aorta using flow-sensitive 4D CMR

被引:181
作者
Buerk, Jonas [1 ]
Blanke, Philipp [1 ]
Stankovic, Zoran [1 ,3 ,4 ]
Barker, Alex [1 ,3 ,4 ]
Russe, Maximilian [1 ]
Geiger, Julia [1 ]
Frydrychowicz, Alex [2 ]
Langer, Mathias [1 ]
Markl, Michael [1 ,3 ,4 ]
机构
[1] Univ Hosp, Dept Diagnost Radiol, Freiburg, Germany
[2] Univ Hosp Schleswig Holstein, Clin Radiol & Nucl Med, Lubeck, Germany
[3] Northwestern Univ, Sch Med, Chicago, IL USA
[4] Northwestern Univ, Dept Biomed Engn, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
4D flow; Flow quantification; Aneurysm of the ascending aorta; MAGNETIC-RESONANCE; IN-VIVO; DESCENDING AORTA; DISSECTION; VISUALIZATION; HEMODYNAMICS; ANEURYSMS;
D O I
10.1186/1532-429X-14-84
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The purpose of this study was to investigate 3D flow patterns and vessel wall parameters in patients with dilated ascending aorta, age-matched subjects, and healthy volunteers. Methods: Thoracic time-resolved 3D phase contrast CMR with 3-directional velocity encoding was applied to 33 patients with dilated ascending aorta (diameter >= 40 mm, age=60 +/- 16 years), 15 age-matched normal controls (diameter <= 37 mm, age=68 +/- 7.5 years) and 15 young healthy volunteers (diameter <= 30 mm, age=23 +/- 2 years). 3D blood flow was visualized and flow patterns were graded regarding presence of supra-physiologic-helix and vortex flow using a semi-quantitative 3-point grading scale. Blood flow velocities, regional wall shear stress (WSS), and oscillatory shear index (OSI) were quantified. Results: Incidence and strength of supra-physiologic-helix and vortex flow in the ascending aorta (AAo) was significantly higher in patients with dilated AAo (16/33 and 31/33, grade 0.9 +/- 1.0 and 1.5 +/- 0.6) than in controls (2/15 and 7/15, grade 0.2 +/- 0.6 and 0.6 +/- 0.7, P<.05) or healthy volunteers (1/15 and 0/15, grade 0.1 +/- 0.3 P<.05). Greater strength of the ascending aortic helix and vortex flow were associated with significant differences in AAo diameters (P<.05). Peak systolic WSS in the ascending aorta and aortic arch was significantly lower in patients with dilated AAo (P<.0157-.0488). AAo diameter positively correlated to time to peak systolic velocities (r=0.30-0.53, P<.04), OSI (r=0.33-0.49, P<0.02) and inversely correlated to peak systolic WSS (r=0.32-0.40, P<.03). Peak systolic WSS was significantly lower in AAo aneurysms at the right and outer curvature within the AAo and proximal arch (P<.01-.05). Conclusions: Increase in AAo diameter is significantly correlated with the presence and strength of supra-physiologichelix and vortex formation in the AAo, as well with decrease in systolic WSS and increase in OSI.
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页数:11
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