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JOURNAL OF MAGNETIC RESONANCE IMAGING 2012年第5期36卷 1015-1036页

作者： Markl, Michael Frydrychowicz, Alex Kozerke, Sebastian Hope, Mike Wieben, Oliver Northwestern Univ Feinberg Sch Med Dept Radiol Chicago IL 60611 USA Northwestern Univ Dept Biomed Engn Chicago IL 60611 USA Univ Schleswig Holstein Dept Radiol Lubeck Germany Univ Wisconsin Dept Radiol Madison WI 53706 USA Univ Zurich Inst Biomed Engn CH-8006 Zurich Switzerland Swiss Fed Inst Technol Zurich Switzerland Univ Calif San Francisco San Francisco CA 94143 USA Univ Wisconsin Dept Med Phys Madison WI 53706 USA Univ Wisconsin Dept Biomech Engn Madison WI USA

Traditionally, magnetic resonance imaging (mri) of flow using phase contrast (PC) methods is accomplished using methods that resolve single-directional flow in two spatial dimensions (2d) of an individual slice. More recently, three-dimensional (3d) spatial encoding combined with three-directional velocity-encoded phase contrast mri (here termed 4d flow mri) has drawn increased attention. 4d flow mri offers the ability to measure and to visualize the temporal evolution of complex blood flow patterns within an acquired 3d volume. Various methodological improvements permit the acquisition of 4d flow mri data encompassing individual vascular structures and entire vascular territories such as the heart, the adjacent aorta, the carotid arteries, abdominal, or peripheral vessels within reasonable scan times. To subsequently analyze the flow data by quantitative means and visualization of complex, three-directional blood flow patterns, various tools have been proposed. This review intends to introduce currently used 4d flow mri methods, including Cartesian and radial data acquisition, approaches for accelerated data acquisition, cardiac gating, and respiration control. Based on these developments, an overview is provided over the potential this new imaging technique has in different parts of the body from the head to the peripheral arteries. J. Magn. Reson. Imaging 2012;36:10151036. (c) 2012 Wiley Periodicals, Inc.

关键词： 4d flow mri blood flow phase contrast respiration control PC-VIPR self-gating intracranial arteries carotid bifurcation aorta pulmonary arteries heart hepatic arteries renal arteries peripheral arteries hemodynamics

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Non-invasive quantification of pressure drops in stenotic intracranial vessels: using deep learning-enhanced 4d flow mri to characterize the regional haemodynamics of the pulsing brain

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INTERFACE FOCUS 2025年第1期15卷 20240040页

作者： El Ahmar, Ali Schnell, Susanne Ansari, Sameer A. Abdalla, Ramez N. Vali, Alireza Aristova, Maria Markl, Michael Winter, Patrick Marlevi, david Univ Greifswald Fac Math & Nat Sci Dept Med Phys Greifswald Germany Northwestern Univ Feinberg Sch Med Dept Radiol Evanston IL USA Northwestern Univ Feinberg Sch Med Dept Neurol & Neurol Surg Chicago IL USA Qualcomm Technol Inc Santa Clara CA USA Karolinska Inst Dept Mol Med & Surg Solna Sweden MIT Inst Med Engn & Sci Cambridge MA USA

Stenosis of major intracranial arteries is a significant cause of stroke, with assessment of trans-stenotic pressure drops being a key marker of functional stenosis severity. Non-invasive methods for quantifying intracranial pressure changes are hence crucial;however, the narrow and tortuous cerebrovascular network poses challenges to traditional assessment methods such as transcranial doppler. This study investigates the use of novel deep learning-enhanced super-resolution (SR) four-dimensional (4d) flow magnetic resonance imaging (mri) in combination with a physics-informed virtual work-energy relative pressure technique to quantify pressure drops across stenotic intracranial arteries. Performance was validated in intracranial-mimicking in vitro experiments using pulsatile flow before being transferred into an in vivo cohort of patients with intracranial atherosclerotic disease. Conversion into sub-millimetre SR imaging significantly improved the accuracy of regional relative pressure estimations in the pulsing brain arteries, mitigating biases observed at >1 mm resolution imaging, and agreeing strongly with reference catheter-based invasive measurements across both moderate and severe stenoses. The in vivo analysis also revealed a significant increase in pressure drops when converting into sub-millimetre SR data, underlining the importance of apparent image resolution in a clinical setting. The results highlight the potential of SR 4d flow mri for non-invasive quantification of cerebrovascular pressure changes in pulsing intracranial arteries across stenotic vessel segments.

关键词： pulsing brain trans-stenotic pressure drop 4d flow mri super-resolution intracranial atherosclerotic disease

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Validation of Left Ventricular High Frame Rate Echo-Particle Image Velocimetry against 4d flow mri in Patients

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ULTRASOUNd IN MEdICINE ANd BIOLOGY 2025年第1期51卷 94-101页

作者： Han, Yichuang Bowen, daniel J. Barreto, Bernardo Loff Zwaan, Robert. R. Strachinaru, Mihai van der Geest, Rob J. Hirsch, Alexander van den Bosch, Annemien E. Bosch, Johan G. Voorneveld, Jason Erasmus MC Cardiovasc Inst Thorax Ctr Dept Cardiol Dr Molewaterplein 40 NL-3015 GD Rotterdam Netherlands Brussels Univ Hosp Erasme Hosp Dept Cardiol Brussels Belgium Erasmus MC Dept Radiol & Nucl Med Rotterdam Netherlands Leiden Univ Med Ctr Dept Radiol Leiden Netherlands

Objective: Accurately measuring intracardiac flow patterns could provide insights into cardiac disease pathophysiology, potentially enhancing diagnostic and prognostic capabilities. This study aims to validate Echo-Particle Image Velocimetry (echoPIV) for in vivo left ventricular intracardiac flow imaging against 4d flow mri. Methods: We acquired high frame rate contrast-enhanced ultrasound images from three standard apical views of 26 patients who required cardiac mri. 4d flow mri was obtained for each patient. Only echo image planes with sufficient quality and alignment with mri were included for validation. Regional velocity, kinetic energy (KE) and viscous energy loss (EL_) were compared between modalities using normalized mean absolute error (NMAE), cosine similarity and Bland-Altman analysis. Results: Among 24 included apical view acquisitions, we observed good correspondence between echoPIV and mri regarding spatial flow patterns and vortex traces. The velocity profile at base-level (mitral valve) cross-section had cosine similarity of 0.92 +/- 0.06 and NMAE of (14 +/- 5)%. Peak spatial mean velocity differed by (3 +/- 6) cm/s in systole and (6 +/- 10) cm/s in diastole. The KE and rate of EL _ also revealed a high level of cosine similarity (0.89 +/- 0.09 and 0.91 +/- 0.06) with NMAE of (23 +/- 7)% and (52 +/- 16)%. Conclusion: Given good B-mode image quality, echoPIV provides a reliable estimation of left ventricular flow, exhibiting spatial-temporal velocity distributions comparable to 4d flow mri. Both modalities present respective strengths and limitations: echoPIV captured inter-beat variability and had higher temporal resolution, while mri was more robust to patient BMI and anatomy.

关键词： Echocardiography Echo-particle image velocimetry 4d flow mri Intracardiac flow pattern dilated cardiomyopathy

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Referenceless 4d flow mri using radial balanced SSFP at 0.6 T

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MAGNETIC RESONANCE IN MEdICINE 2025年第0期 2025 Mar 19页

作者： Mcgrath, Charles dirix, Pietro Vousten, Vincent Smink, Jouke Ercan, Ece Boernert, Peter Kozerke, Sebastian Univ & ETH Zurich Inst Biomed Engn Gloriastr 35 CH-8092 Zurich Switzerland Philips Healthcare Best Netherlands Philips Innovat Technol Hamburg Germany

PurposeTo implement four-dimensional-flow mri using phase-contrast balanced steady-state free precession (bSSFP) at 0.6 T using a free-running three-dimensional (3d) radial trajectory and referenceless background phase *** free-running, wobbling Archimedean spiral approach including bipolar velocity-encoding gradients (3d PC-bSSFP) was implemented on a 0.6T prototype scanner. Bipolar rewinder gradients were added to ensure first-moment nulling per repetition time. Velocity encoding was performed using a three-point encoding scheme (i.e., omitting a reference measurement). Advanced computer simulations were carried out to validate the approach. Image reconstruction was performed using a locally low-rank approach. Results for anatomical visualization and flow quantification were reconstructed separately with different regularization factors. Background phase correction was achieved using phase estimation on time-averaged reconstructions. In vivo data were acquired in 6 healthy subjects during free breathing. Additional two-dimensional (2d) phase-contrast spoiled gradient-echo (2d PC-GRE) breath-hold data were obtained for reference to compare flow values in the ascending aorta, descending aorta, and pulmonary *** data acquired with 3d PC-bSSFP compared well with 2d PC-GRE (root mean square error = 3.96 cm/s), with minor underestimation of velocities (-0.52 cm/s). Cardiac phase-dependent signal-to-noise ratios normalized for differences in scan time and resolution between 3d PC-bSSFP and 2d PC-GRE demonstrate relatively steady values for 3d PC-bSSFP when compared to 2d PC-bSSFP with some reduction during phases of high ***-running, referenceless, four-dimensional-flow mri using radial 3d PC-bSSFP is feasible on a lower-field 0.6T system, producing adequate flow quantification while yielding simultaneously reasonable cine images for concurrent flow and functional assessment of the heart and great vessels.

关键词： 4d flow mri balanced steady state free precession blood flow quantification low field phase contrast

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Super-Resolving and denoising 4d flow mri of Neurofluids Using Physics-Guided Neural Networks

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ANNALS OF BIOMEdICAL ENGINEERING 2025年第2期53卷 331-347页

作者： Patel, Neal M. Bartusiak, Emily R. Rothenberger, Sean M. Schwichtenberg, A. J. delp, Edward J. Rayz, Vitaliy L. Purdue Univ Biomed Engn W Lafayette IN 47907 USA Purdue Univ Elect & Comp Engn W Lafayette IN USA Purdue Univ Hlth & Human Sci W Lafayette IN USA Purdue Univ Psychol Sci W Lafayette IN USA Purdue Univ Mech Engn W Lafayette IN 47907 USA

PurposeTo obtain high-resolution velocity fields of cerebrospinal fluid (CSF) and cerebral blood flow by applying a physics-guided neural network (div-mdCSRN-flow) to 4d flow *** div-mdCSRN-flow network was developed to improve spatial resolution and denoise 4d flow mri. The network was trained with patches of paired high-resolution and low-resolution synthetic 4d flow mri data derived from computational fluid dynamic simulations of CSF flow within the cerebral ventricles of five healthy cases and five Alzheimer's disease cases. The loss function combined mean squared error with a binary cross-entropy term for segmentation and a divergence-based regularization term for the conservation of mass. Performance was assessed using synthetic 4d flow mri in one healthy and one Alzheimer' disease cases, an in vitro study of healthy cerebral ventricles, and in vivo 4d flow imaging of CSF as well as flow in arterial and venous blood vessels. Comparison was performed to trilinear interpolation, divergence-free radial basis functions, divergence-free wavelets, 4dflowNet, and our network without divergence *** proposed network div-mdCSRN-flow outperformed other methods in reconstructing high-resolution velocity fields from synthetic 4d flow mri in healthy and Ad cases. The div-mdCSRN-flow network reduced error by 22.5% relative to linear interpolation for in vitro core voxels and by 49.5% in edge *** results demonstrate generalizability of our 4d flow mri super-resolution and denoising approach due to network training using flow patches and physics-based constraints. The mdCSRN-flow network can facilitate mri studies involving CSF flow measurements in cerebral ventricles and association of mri-based flow metrics with cerebrovascular health.

关键词： 4d flow mri CSF Physics-guided neural networks Machine learning

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Cluster analysis of 100 Marfan patients based on aortic 4d flow mri and Z-score: insights into disease heterogeneity and stratification of subgroups

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EUROPEAN RAdIOLOGY 2025年第4期35卷 2200-2212页

作者： Lenz, Alexander Bahr, Flora Riedel, Christoph Wright, Felicia Sinn, Martin Zhang, Shuo Schuett, Marion Well, Lennart Adam, Gerhard von Kodolitsch, Yskert Schoennagel, Bjoern P. Bannas, Peter Univ Med Ctr Hamburg Eppendorf Dept Diagnost & Intervent Radiol & Nucl Med Hamburg Germany Philips GmbH Market DACH Clin Sci Dept Imaging Syst Hamburg Germany Univ Med Ctr Hamburg Eppendorf Inst Med Biometry & Epidemiol Hamburg Germany Univ Heart & Vasc Ctr Hamburg Dept Cardiovasc Med Hamburg Germany

Objectives 4d flow mri-derived variables from Marfan patients are highly heterogeneous. Our aim was to identify distinct Marfan patient subgroups based on aortic 4d flow mri and Z-score for stratification of distinct hemodynamic profiles and clinical features by means of hierarchical cluster analysis. Materials and methods One hundred Marfan patients underwent baseline aortic 4d flow mri at 3 T. Z-scores, degree of helical and vortical flow, wall shear stress, flow displacement, and peak velocity were determined in the ascending aorta. Sex, age, BMI, antihypertensive medication, and dural ectasia were recorded. Hierarchical cluster analysis was performed using 4d flow mri variables and Z-scores as input. Results Cluster analysis resulted in three distinct clusters characterized by different Z-scores (mean +/- Sd);cluster 1: 0.4 +/- 1.1 vs. cluster 2: 3.1 +/- 1.1 vs. cluster 3: 3.6 +/- 1.9. The three clusters delivered differences in helical and vortical flow patterns (global p = 0.003 and p < 0.001, respectively), wall shear stress (0.49 +/- 0.11 vs. 0.44 +/- 0.12 vs. 0.37 +/- 0.09 N/m(2), global p < 0.001), flow displacement (0.11 +/- 0.05 vs. 0.16 +/- 0.08 vs. 0.15 +/- 0.07, global p = 0.006), and peak velocity (76.3 +/- 9.0 vs. 60.1 +/- 7.3 vs. 56.0 +/- 7.8 cm/s, global p < 0.001). Patients in cluster 1 and 2 were relevantly younger than in cluster 3 (32.3 +/- 13.8 vs. 32.8 +/- 12.6 vs. 40.2 +/- 15.0 years, all pairwise triangle p < 0.0297). Conclusion Hierarchical cluster analysis based on aortic 4d flow mri and Z-score revealed three distinct subgroups of Marfan patients, each characterized by specific hemodynamic profiles and clinical features. Follow-up of our patients is warranted to assess if 4d flow mri- and Z-score-based stratification can predict future aortic diameter growth and ultimately improve outcomes. Clinical relevance statement A combination of Z-score and 4d flow mri-derived parameters may help identify subgroups of Marfan patients representing

关键词： 4d flow mri Marfan syndrome Congenital heart disease Aneurysm Thoracic aorta

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3d Vortex-Energetics in the Left Pulmonary Artery for differentiating Pulmonary Arterial Hypertension and Pulmonary Venous Hypertension Groups Using 4d flow mri

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JOURNAL OF MAGNETIC RESONANCE IMAGING 2025年第5期61卷 2130-2143页

作者： Elbaz, Mohammed S. M. Shafeghat, Melika Freed, Benjamin H. Sarnari, Roberto Zilber, Zachary Avery, Ryan Markl, Michael Allen, Bradley d. Carr, James Northwestern Univ Radiol Chicago IL USA Northwestern Univ Cardiol Chicago IL USA

Background: Pulmonary hypertension (PH) is a life-threatening. differentiation pulmonary arterial hypertension (PAH) from pulmonary venous hypertension (PVH) is important due to distinct treatment protocols. Invasive right heart catheterization (RHC) remains the reference standard but noninvasive alternatives are needed. Purpose/Hypothesis: To evaluate 4d flow mri-derived 3d vortex energetics in the left pulmonary artery (LPA) for distinguishing PAH from PVH. Study Type: Prospective case-control. Population/Subjects: Fourteen PAH patients (11 female) and 18 PVH patients (9 female) diagnosed from RHC, 23 healthy controls (9 female). Field Strength/Sequence: 1.5 T;gradient recalled echo 4d flow and balanced steady-state free precession (bSSFP) cardiac cine sequences. Assessment: LPA 3d vortex cores were identified using the lambda2 method. Peak vortex-contained kinetic energy (vortex-KE) and viscous energy loss (vortex-EL) were computed from 4d flow mri. Left and right ventricular (LV, RV) stroke volume (LVSV, RVSV) and ejection fraction (LVEF, RVEF) were computed from bSSFP. In PH patients, mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWR) and pulmonary vascular resistance (PVR) were determined from RHC. Statistical Tests: Mann-Whitney U test for group comparisons, Spearman's rho for correlations, logistic regression for identifying predictors of PAH vs. PVH and develop models, area under the receiver operating characteristic curve (AUC) for model performance. Significance was set at P < 0.05. Results: PAH patients showed significantly lower vortex-KE (37.14 [14.68-78.521 vs. 76.48 [51.07-120.511) and vortex-EL (9.93 [5.69-25.701 vs. 24.22 [12.20-32.011) than PVH patients. The combined vortex-KE and LVEF model achieved an AUC of 0.89 for differentiating PAH from PVH. Vortex-EL showed significant negative correlations with mPAP (rho =-0.43), PCWP (rho = 0.37), PVR (rho =-0.64). In the PAH group, PVR was significantly negatively correlate

关键词： pulmonary hypertension 4d flow mri pulmonary arterial hypertension pulmonary venous hypertension vortex flow

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Fully Automated Valve Segmentation for Blood flow Assessment From 4d flow mri Including Automated Cardiac Valve Tracking and Transvalvular Velocity Mapping

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JOURNAL OF MAGNETIC RESONANCE IMAGING 2025年第1期61卷 198-208页

作者： de Braekt, Thomas In Aben, Jean-Paul Maussen, Marc van den Bosch, Harrie C. M. Houthuizen, Patrick Roest, Arno A. W. van den Boogaard, Pieter J. Lamb, Hildo J. Westenberg, Jos J. M. Catharina Hosp Dept Radiol Eindhoven Netherlands Leiden Univ Med Ctr Dept Radiol Leiden Netherlands Pie Med Imaging BV Maastricht Netherlands Catharina Hosp Dept Cardiol Eindhoven Netherlands Leiden Univ Med Ctr Dept Pediat Cardiol Leiden Netherlands

Background: Automated 4d flow mri valvular flow quantification without time-consuming manual segmentation might improve workflow. Purpose: Compare automated valve segmentation (AS) to manual (MS), and manually corrected automated segmentation (AMS), in corrected atrioventricular septum defect (c-AVSd) patients and healthy volunteers, for assessing net forward volume (NFV) and regurgitation fraction (RF). Study Type: Retrospective. Population: 27 c-AVSd patients (median, 23 years;interquartile range, 16-31 years) and 24 healthy volunteers (25 years;12.5-36.5 years). Field strength/Sequence: Whole-heart 4d flow mri and cine steady-state free precession at 3T. Assessment: After automatic valve tracking, valve annuli were segmented on time-resolved reformatted trans-valvular velocity images by AS, MS, and AMS. NFV was calculated for all valves, and RF for right and left atrioventricular valves (RAVV and LAVV). NFV variation (standard deviation divided by mean NFV) and NFV differences (NFV difference of a valve vs. mean NFV of other valves) expressed internal NFV consistency. Statistical Tests: Comparisons between methods were assessed by Wilcoxon signed-rank tests, and intra/interobserver variability by intraclass correlation coefficients (ICCs). P < 0.05 was considered statistically significant, with multiple testing correction. Results: AMS mean analysis time was significantly shorter compared with MS (5.3 +/- 1.6 minutes vs. 9.1 +/- 2.5 minutes). MS NFV variation (6.0%) was significantly smaller compared with AMS (6.3%), and AS (8.2%). Median NFV difference of RAVV, LAVV, PV, and AoV between segmentation methods ranged from -0.7-1.0 mL, -0.5-2.8 mL, -1.1-3.6 mL, and - 3.1--2.1 mL, respectively. Median RAVV and LAVV RF, between 7.1%-7.5% and 3.8%-4.3%, respectively, were not significantly different between methods. Intraobserver/interobserver agreement for AMS and MS was strong-to-excellent for NFV and RF (ICC >= 0.88). data Conclusion: MS demonstrates strongest inter

关键词： 4d flow mri automated valve segmentation net flow volume postprocessing analysis time regurgitation fraction

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Synthesizing Scalable CFd-Enhanced Aortic 4d flow mri for Assessing Accuracy and Precision of deep-Learning Image Reconstruction and Segmentation Tasks 9th

Synthesizing Scalable CFD-Enhanced Aortic 4D Flow MRI for As...

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9th International Workshop on Simulation and Synthesis in Medical Imaging

作者： dirix, Pietro Jacobs, Luuk Buoso, Stefano Kozerke, Sebastian Univ & ETH Zurich Inst Biomed Engn Zurich Switzerland

ISBN: (纸本)9783031732805;9783031732812

Systematic and random errors of mri measurements in conjunction with the absence of ground truth data limit the assessment of accuracy and precision of 4d flow mri image reconstruction and other downstream tasks. In this work, we propose to generate scalable synthetic CFd-enhanced aortic 4d flow mri data, which we assemble into a dataset named RACLETTE. Our approach takes in-vivo 4d flow mri data as input and pairs it with CFd-based "ground-truth" mean and turbulent flow fields. Specifically, high-resolution pulsatile velocity-vector and turbulent flow fields are simulated for varying degrees of aortic stenosis for a set of 139 time-resolved compliant aortic geometries. To generate realistic datasets, the synthetic flow fields are projected and embedded into the background of the in-vivo 4d flow mri scans. Upon Fourier transform, data sampling using a given velocity encoding and undersampling scheme yields k-space data as input to deep-learning image reconstruction, segmentation and other downstream tasks. Since the synthetic 4d flow mri data is paired with noise-free reference values including velocity, pressure, wall shear stress, the Reynolds stress tensor and pulse wave velocity, accuracy and precision of reconstruction and inference are readily available. To demonstrate the value of synthetic CFd-enhanced 4d flow mri data, we utilize the dataset to train and apply (1) deep-learning based image reconstruction and (2) automatic vessel segmentation. It is shown that the synthetically trained deep-learning tasks generalize sufficiently and provide insights into the performance of reconstruction and processing tasks, indicating the potential value of our synthetic dataset also for further applications.

关键词： 4d flow mri data synthesis Computational Fluid dynamics deep learning Image reconstruction Vessel segmentation

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Hemodynamic Analysis Using 4d flow mri in a Case of Aortic dissection With Aberrant Right Subclavian Artery

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CLINICAL CASE REPORTS 2025年第1期13卷

作者： Sakakibara, Kenji Nakajima, Hiroyuki Yoshida, Yukiyo Hagihara, Yudai Nakamura, Chie Shikata, daichi Takesue, Yuki Shiraiwa, Satoru Honda, Yoshihiro Kaga, Shigeaki Hamasaki, Masahiro Johno, Hisashi Watanabe, Hiroaki Univ Yamanashi Fac Med Dept Surg 2 Yamanashi Japan Univ Yamanashi Fac Med Dept Radiol Yamanashi Japan

Four-dimensional flow magnetic resonance imaging (4d flow mri) was utilized to analyze an aortic dissection with an aberrant right subclavian artery, revealing vortex formation and an increased oscillatory shear index (OSI), both indicative of variations in wall shear stress. An elevated OSI has been associated with an elevated risk of aortic dissection.

关键词： 4d flow mri aberrant right subclavian artery aortic dissection oscillatory shear index

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