Abstract

Four-dimensional (4D) flow MRI allows quantifying flow in blood vessels–non invasively and in vivo. The clinical use of 4D flow MRI in small vessels, however, is hampered by long examination times and limited spatial resolution. Compressed SENSE (CS-SENSE) is a technique that can accelerate 4D flow dramatically. Here, we investigated the effect of spatial resolution and CS acceleration on flow measurements by using 4D flow MRI in small vessels in vitro at 3 T. We compared the flow in silicon tubes (inner diameters of 2, 3, 4, and 5 mm) measured with 4D flow MRI, accelerated with four CS factors (CS = 2.5, 4.5, 6.5, and 13) and three voxel sizes (0.5, 1, and 1.5 mm3) to 2D flow MRI and a flow sensor. Additionally, the velocity field in an aneurysm model acquired with 4D flow MRI was compared to the one simulated with computational fluid dynamics (CFD). A strong correlation was observed between flow sensor, 2D flow MRI, and 4D flow MRI (rho > 0.94). The use of fewer than seven voxels per vessel diameter (nROI) resulted in an overestimation of flow in more than 5% of flow measured with 2D flow MRI. A negative correlation (rho = −0.81) between flow error and nROI were found for CS = 2.5 and 4.5. No statistically significant impact of CS factor on differences in flow rates was observed. However, a trend of increased flow error with increased CS factor was observed. In an aneurysm model, the peak velocity and stagnation zone were detected by CFD and all 4D flow MRI variants. The velocity difference error in the aneurysm sac did not exceed 11% for CS = 4.5 in comparison to CS = 2.5 for all spatial resolutions. Therefore, CS factors from 2.5–4.5 can appear suitable to improve spatial or temporal resolution for accurate quantification of flow rate and velocity. We encourage reporting the number of voxels per vessel diameter to standardize 4D flow MRI protocols.

Highlights

  • Blood flow is altered in a variety of intracranial diseases, such as arterial stenosis [1,2], intracranial aneurysms [3,4], and vascular malformations [5]

  • The flow patterns obtained using the US sensor and 2D flow MRI were qualitatively similar to those obtained with 4D flow MRI for all voxel sizes and compressed SENSE (CS) acceleration factors (Figure 2)

  • We report the results of the comparison between 4D and 2D flow, while the quantitative comparison between flow obtained with a US sensor and 4D flow MRI is presented in a supplement to this paper (Figures S2 and S3, Tables S3 and S4)

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Summary

Introduction

Blood flow is altered in a variety of intracranial diseases, such as arterial stenosis [1,2], intracranial aneurysms [3,4], and vascular malformations [5]. Four-dimensional (4D) phase-contrast magnetic resonance imaging (4D flow MRI) is a noninvasive technique and can be used to quantitatively and qualitatively analyze the hemodynamics of blood vessels [6]. It can provide time-resolved 3D visualization of complex flow patterns and quantify flow rates, velocities, and more advanced parameters, such as wall shear stress (WSS) and oscillatory shear index (OSI) [7,8,9,10]. 4D flow MRI has been used primarily for research purposes to study intracranial aneurysms, arteriovenous malformation, and Alzheimer’s disease, among others [11]. Neurovascular 4D flow MRI can potentially be used to monitor the effect of aneurysm therapy [12,13,14]

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