Four-dimensional flow assessment of pulmonary artery flow and wall shear stress in adult pulmonary arterial hypertension: Results from two institutions

• Published in: Magnetic resonance in medicine Vol. 73; no. 5; pp. 1904 - 1913
• Main Authors: Barker, Alex J., Roldán-Alzate, Alejandro, Entezari, Pegah, Shah, Sanjiv J., Chesler, Naomi C., Wieben, Oliver, Markl, Michael, François, Christopher J.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2015; Wiley Subscription Services, Inc
• Subjects: 4D flow MRI; Adult; Aged; Blood Flow Velocity - physiology; Female; Hemodynamics - physiology; Humans; Hypertension, Pulmonary - physiopathology; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Magnetic Resonance Angiography - methods; Male; Middle Aged; Observer Variation; Pulmonary Artery - physiology; Pulmonary Embolism - physiopathology; pulmonary hypertension; Reference Values; Scleroderma, Systemic - physiopathology; Sensitivity and Specificity; Shear Strength; Stroke Volume - physiology; Systole - physiology; wall shear stress; 4D flow MRI; pulmonary hypertension; wall shear stress
• ISSN: 0740-3194; 1522-2594; 1522-2594
• DOI: 10.1002/mrm.25326

Purpose To compare pulmonary artery flow using Cartesian and radially sampled four‐dimensional flow‐sensitive (4D flow) MRI at two institutions. Methods Nineteen healthy subjects and 17 pulmonary arterial hypertension (PAH) subjects underwent a Cartesian 4D flow acquisition (institution 1) or a three‐dimensional radial acquisition (institution 2). The diameter, peak systolic velocity (Vmax), peak flow (Qmax), stroke volume (SV), and wall shear stress (WSS) were computed in two‐dimensional analysis planes at the main, right, and left pulmonary artery. Interobserver variability, interinstitutional differences, flow continuity, and the hemodynamic measurements in healthy and PAH subjects were assessed. Results Vmax, Qmax, SV, and WSS at all locations were significantly lower (P < 0.05) in PAH compared with healthy subjects. The limits of agreement were 0.16 m/s, 2.4 L/min, 10 mL, and 0.31 N/m2 for Vmax, Qmax, SV, and WSS, respectively. Differences between Qmax and SV using Cartesian and radial sequences were not significant. Plane placement and acquisition exhibited isolated, site‐based differences between Vmax and WSS. Conclusions 4D flow MRI was used to detect differences in pulmonary artery hemodynamics for PAH subjects. Flow and WSS in healthy and PAH subject cohorts were similar between Cartesian‐ and radial‐based 4D flow MRI acquisitions with minimal interobserver variability. Magn Reson Med 73:1904–1913, 2015. © 2014 Wiley Periodicals, Inc.