Assessment of intracardiac flow and vorticity in the right heart of patients after repair of tetralogy of Fallot by flow-sensitive 4D MRI.
Assessment of intracardiac flow and vorticity in the right heart of patients after repair of tetralogy of Fallot by flow-sensitive 4D MRI.
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DOI：
10.1007/s00330-015-4186-1
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发表时间：
2016-10
影响因子：
5.9
通讯作者：
Geiger J
中科院分区：
文献类型：
--
作者：
Hirtler D;Garcia J;Barker AJ;Geiger J
全面定量分析法乐四联症（rTOF）修复术后患者右心血流和涡度，并与健康志愿者进行比较。在24例rTOF患者和12例志愿者中获得了时间分辨血流敏感4D MRI。定性流动评价是基于两个观察员的共识阅读。定量分析包括在4腔视图中分割右心房（RA）和心室（RV），以提取体积和区域血流动力学信息，用于计算区域平均和峰值涡度。右心心房内、心室内和流出道血流模式在rTOF患者和志愿者之间存在显著差异。患者的峰值RA和平均RV涡度显著更高（p=0.02/0.05）。右室和右心房最大和平均涡度与心室容积呈显著负相关（p<0.05）。主肺动脉（MPA）反流与较高的RA和RV涡度相关，这对RA最大涡度和RV平均涡度具有显著性（p=0.01/0.03）。与定性血流可视化相比，基于4D血流数据的涡度计算是评估rTOF患者心内血流变化的替代方法。心内涡度的改变可能与右心室扩张和功能受损的发展有关。
To comprehensively and quantitatively analyze flow and vorticity in the right heart of patients after repair of tetralogy of Fallot (rTOF) compared with healthy volunteers. Time-resolved flow-sensitive 4D MRI was acquired in 24 rTOF patients and 12 volunteers. Qualitative flow evaluation was based on consensus reading of two observers. Quantitative analysis included segmentation of the right atrium (RA) and ventricle (RV) in a 4-chamber view to extract volumes and regional hemodynamic information for computation of regional mean and peak vorticity. Right heart intra-atrial, intraventricular and outflow tract flow patterns differed considerably between rTOF patients and volunteers. Peak RA and mean RV vorticity was significantly higher in patients (p=0.02/0.05). Significant negative correlations were found between patients’ maximum and mean RV and RA vorticity and ventricular volumes (p<0.05). The main pulmonary artery (MPA) regurgitant flow was associated with higher RA and RV vorticity, which was significant for RA maximum and RV mean vorticity (p=0.01/0.03). The calculation of vorticity based on 4D flow data is an alternative approach to assess intracardiac flow changes in rTOF patients compared with qualitative flow visualization. Alterations in intracardiac vorticity could be relevant with regard to the development of RV dilation and impaired function.