Intraindividual validation of 4D flow measurement against 2D flow measurements in complex flow patterns in routine clinical cardiovascular magnetic resonance of bicuspid aortic valve
Background Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four...
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| Published in | Egyptian Journal of Radiology and Nuclear Medicine Vol. 51; no. 1; pp. 222 - 8 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
06.11.2020
Springer Springer Nature B.V SpringerOpen |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0378-603X 2090-4762 |
| DOI | 10.1186/s43055-020-00331-x |
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| Abstract | Background
Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error.
Results
The two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were − 8 and − 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/− 28 ml and + 14/− 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/− 18 ml and + 12/− 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers.
Conclusion
Inter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4–9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. |
|---|---|
| AbstractList | Background
Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error.
Results
The two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were − 8 and − 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/− 28 ml and + 14/− 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/− 18 ml and + 12/− 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers.
Conclusion
Inter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4–9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. Abstract Background Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error. Results The two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were − 8 and − 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/− 28 ml and + 14/− 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/− 18 ml and + 12/− 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers. Conclusion Inter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4–9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. BackgroundComparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error.ResultsThe two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were − 8 and − 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/− 28 ml and + 14/− 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/− 18 ml and + 12/− 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers.ConclusionInter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4–9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. Background Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error. Results The two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were - 8 and - 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/- 28 ml and + 14/- 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/- 18 ml and + 12/- 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers. Conclusion Inter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4-9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare four-dimensional against the two-dimensional flow measurement in patients with bicuspid aortic valve and to test potentials of four-dimensional operator-dependent sources of error. The two- and four-dimensional flow data sets of sixteen patients with bicuspid aortic valve and eighteen healthy subjects were studied. Flow analyses were performed by two observers blindly. Patients with bicuspid aortic valve mean differences between the two- and four-dimensional measurements in both observers were - 8 and - 4 ml, respectively. Four-dimensional measurements resulted in systematically higher flow values than the two-dimensional flow in bicuspid aortic valve patients. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 12/- 28 ml and + 14/- 21 ml, respectively. In the healthy volunteers, mean differences between the two- and four-dimensional measurements in both observers were ± 0 and + 1 ml, respectively. The upper and lower limits of agreement between the two- and four-dimensional measurements by both observers were + 21/- 18 ml and + 12/- 13 ml, respectively. Inter-observer variability in four-dimensional flow measurement was 4% mean net forward flow in bicuspid aortic valve patients and 8% in healthy volunteers. Inter-observer variability in four-dimensional flow assessment is 8% or less which is acceptable for clinical cardiac MRI routine. There is close agreement of two- and four-dimensional flow tools in normal and complex flow pattern. In complex flow pattern, however, four-dimensional flow measurement picks up 4-9% higher flow values. It seems, therefore, that four-dimensional flow is closer to real flow values than two-dimensional flow, which is however to be proven by further studies. |
| Audience | Professional Academic |
| Author | Huellebrand, Markus Martinoff, Stefan Ewert, Peter Kharabish, Ahmed Meierhofer, Christian Hennemuth, Anja Stern, Heiko Belker, Kristina |
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| References_xml | – ident: CR19 – volume: 62 start-page: 984 year: 2009 end-page: 992 ident: CR16 article-title: Four-dimensional (4D) flow of the whole heart and great vessels using real-time respiratory self-gating publication-title: Magn Reson Med doi: 10.1002/mrm.22090 – ident: CR4 – ident: CR14 – volume: 14 start-page: 797 year: 2013 end-page: 804 ident: CR11 article-title: Wall shear stress and flow patterns in the ascending aorta in patients with bicuspid aortic valves differ significantly from tricuspid aortic valves: a prospective study publication-title: Eur Heart J Cardiovasc Imaging doi: 10.1093/ehjci/jes273 – ident: CR17 – ident: CR10 – volume: 33 start-page: 1069 issue: 7 year: 2017 end-page: 1081 ident: CR15 article-title: Unravelling cardiovascular disease using four dimensional flow cardiovascular magnetic resonance publication-title: Int J Cardiovasc Imaging doi: 10.1007/s10554-016-1031-9 – ident: CR9 – volume: 7 start-page: 52 year: 2005 end-page: 58 ident: CR3 article-title: Evaluation of intracardiac shunts with cardiac magnetic resonance publication-title: Curr Cardiol Rep doi: 10.1007/s11886-005-0011-9 – volume: 9 start-page: 723 year: 2007 end-page: 728 ident: CR1 article-title: Flow measurement by magnetic resonance: a unique asset worth optimising publication-title: J Cardiovasc Magn Reson doi: 10.1080/10976640701465090 – volume: 23 start-page: 3262 issue: 22 year: 2017 end-page: 3267 ident: CR18 article-title: Novel insights into complex cardiovascular pathologies using 4D flow analysis by cardiovascular magnetic resonance imaging publication-title: Curr Pharm Des doi: 10.2174/1381612823666170317144257 – volume: 37 start-page: 208 year: 2013 end-page: 216 ident: CR12 article-title: Four-dimensional velocity-encoded magnetic resonance imaging improves blood flow quantification in patients with complex accelerated flow publication-title: J Magn Reson Imaging doi: 10.1002/jmri.23793 – ident: CR5 – volume: 21 start-page: 1651 year: 2011 end-page: 1657 ident: CR6 article-title: 4D-MR flow analysis in patients after repair for tetralogy of Fallot publication-title: Eur Radiol doi: 10.1007/s00330-011-2108-4 – volume: 18 start-page: 53 year: 2002 end-page: 60 ident: CR2 article-title: Quantification of shunt volumes in congenital heart diseases using a breath-hold MR phase contrast technique-comparison with oximetry publication-title: Int J Cardiovasc Imaging doi: 10.1023/A:1014394626363 – volume: 32 start-page: 677 year: 2010 end-page: 683 ident: CR13 article-title: Flow-sensitive four-dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: a validation study publication-title: Magn Reson Imaging doi: 10.1002/jmri.22280 – volume: 35 start-page: 594 year: 2012 end-page: 600 ident: CR7 article-title: Aortic flow patterns in patients with Marfan syndrome assessed by flow-sensitive four-dimensional MRI publication-title: J Magn Reson Imaging doi: 10.1002/jmri.23500 – volume: 143 start-page: 1108 year: 2012 end-page: 1116 ident: CR8 article-title: Visualization of flow structures in Fontan patients using 3-dimensional phase contrast magnetic resonance imaging publication-title: J Thorac Cardiovasc Surg doi: 10.1016/j.jtcvs.2011.09.067 |
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| Snippet | Background
Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed... Background Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed... Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to compare... BackgroundComparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This study aimed to... Abstract Background Comparing four-dimensional flow against two-dimensional flow measurements in patients with complex flow pattern is still lacking. This... |
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| SubjectTerms | 4D flow BAV CHD CMRI Coronary vessels Flow velocity Heart valve diseases Imaging Magnetic resonance imaging Measurement Medicine Medicine & Public Health Nuclear Medicine Pulmonary arteries Radiology Regression analysis Software Statistical significance Veins & arteries |
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| Title | Intraindividual validation of 4D flow measurement against 2D flow measurements in complex flow patterns in routine clinical cardiovascular magnetic resonance of bicuspid aortic valve |
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