Abstract
Background: Chronic descending thoracic aortic dissection (CDTAD) following surgical repair of ascending aortic dissection requires long-term imaging surveillance. We investigated four-dimensional (4D)-flow magnetic resonance imaging (MRI) with a novel multi-velocity encoding (multi-VENC) technique as an emerging clinical method enabling the dynamic quantification of blood volume and velocity throughout the cardiac cycle. Methods: Patients with CDTAD (n = 10; mean age, 55.1 years; standard deviation (SD) 10.8) and healthy volunteers (n = 9; mean age, 37.1 years; SD 11.4; p < 0.01) underwent 3T MRI, and standard views and 4D-flow data were obtained. Flow measurements were made in selected regions of interest within the ascending and descending thoracic aorta. Results: The overall flow profile at peak systole was reduced in the false lumen (FL) compared with the true lumen (TL) and normal aortas (p < 0.05 for velocity < 0.4 m/s). Peak systolic flow rate per aortic lumen area (mL/s/cm 2 ) was lower in the FL than in the TL (p < 0.05), and both rates were lower than that of control aortas (p < 0.05). Blood flow reversal was higher in the FL than in the TL throughout the descending aorta in CDTAD patients (p < 0.05). A derived pulsatility index was elevated in the TL compared with that in the FL in CDTAD patients. Generated pathline images demonstrated flow patterns in detail, including sites of communication between the true and FL. Conclusions: 4D-flow MRI revealed FL blood flow and reduced blood flow velocity and flow rate in the TL of CDTAD patients compared with normal aortas of healthy participants. Thus, multi-VENC 4D-flow MRI could serve as an adjunct in the long-term assessment of CDTAD following surgical repair of ascending aortic dissection.
Highlights
Patients with chronic descending thoracic aortic dissection (CDTAD) following surgical repair of as-Accessible online at: http://aorta.scienceinternational.org cending aortic dissection require continued surveillance throughout their lifetime, as some will develop progressive aortic dilatation [1]
We investigated four-dimensional (4D)flow magnetic resonance imaging (MRI) with a novel multi-velocity encoding technique as an emerging clinical method enabling the dynamic quantification of blood volume and velocity throughout the cardiac cycle
Multi-VENC 4D-flow MRI could serve as an adjunct in the long-term assessment of Chronic descending thoracic aortic dissection (CDTAD) following surgical repair of ascending aortic dissection
Summary
Patients with chronic descending thoracic aortic dissection (CDTAD) following surgical repair of as-Accessible online at: http://aorta.scienceinternational.org cending aortic dissection require continued surveillance throughout their lifetime, as some will develop progressive aortic dilatation [1]. Patients with chronic descending thoracic aortic dissection (CDTAD) following surgical repair of as-. Four dimensional (4D)-flow magnetic resonance imaging (MRI) is an emerging imaging tool that permits accurate quantification of blood flow velocity and volume through the aorta, as well as flow dynamics over time, to be represented as velocity-encoded pathlines [5, 6]. Chronic descending thoracic aortic dissection (CDTAD) following surgical repair of ascending aortic dissection requires long-term imaging surveillance. We investigated four-dimensional (4D)flow magnetic resonance imaging (MRI) with a novel multi-velocity encoding (multi-VENC) technique as an emerging clinical method enabling the dynamic quantification of blood volume and velocity throughout the cardiac cycle. Multi-VENC 4D-flow MRI could serve as an adjunct in the long-term assessment of CDTAD following surgical repair of ascending aortic dissection
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