Highly accelerated aortic 4D flow MRI using compressed sensing: Performance at different acceleration factors in patients with aortic disease

Purpose To systematically assess the feasibility and performance of a highly accelerated compressed sensing (CS) 4D flow MRI framework at three different acceleration factors (R) for the quantification of aortic flow dynamics and wall shear stress (WSS) in patients with aortic disease. Methods Twenty patients with aortic disease (58 +/- 15 y old; 19 M) underwent four 4D flow scans: one conventional (GRAPPA, R = 2) and three CS 4D flows with R = 5.7, 7.7, and 10.2. All scans were acquired with otherwise equivalent imaging parameters on a 1.5T scanner. Peak-systolic velocity (V-max), peak flow (Q(max)), and net flow (Q(net)) were quantified at the ascending aorta (AAo), arch, and descending aorta (DAo). WSS was calculated at six regions within the AAo and arch. Results Mean scan times for the conventional and CS 4D flows with R = 5.7, 7.7, and 10.2 were 9:58 +/- 2:58 min, 3:40 +/- 1:19 min, 2:50 +/- 0:56 min, and 2:05 +/- 0:42 min, respectively. V-max, Q(max), and Q(net) were significantly underestimated by all CS protocols (underestimation <= -7%, -9%, and -10% by CS, R = 5.7, 7.7, and 10.2, respectively). WSS measurements showed the highest underestimation by all CS protocols (underestimation <= -9%, -12%, and -14% by CS, R = 5.7, 7.7, and 10.2). Conclusions Highly accelerated aortic CS 4D flow at R = 5.7, 7.7, and 10.2 showed moderate agreement with the conventional 4D flow, despite systematically underestimating various hemodynamic parameters. The shortened scan time may enable the clinical translation of CS 4D flow, although potential hemodynamic underestimation should be considered when interpreting the results.