Authors:	Varga-Szemes, Akos Halfmann, Moritz Schoepf, Joseph Jin, Ning Kilburg, Anton Dargis, Danielle M. Düber, Christoph Ese, Amir Aquino, Gilberto Xiong, Fei Kreitner, Karl-Friedrich Markl, Michael Emrich, Tilman
Title:	Highly accelerated compressed-sensing 4D flow for intracardiac flow assessment
Online publication date:	19-Jan-2023
Year of first publication:	2022
Language:	english
Abstract:	Background: Four-dimensional (4D) flow MRI allows for the quantification of complex flow patterns; however, its clinical use is limited by its inherently long acquisition time. Compressed sensing (CS) is an acceleration technique that provides substantial reduction in acquisition time. Purpose: To compare intracardiac flow measurements between conventional and CS-based highly accelerated 4D flow acquisitions. Study Type: Prospective. Subjects: Fifty healthy volunteers (28.0 7.1 years, 24 males). Field Strength/Sequence: Whole heart time-resolved 3D gradient echo with three-directional velocity encoding (4D flow) with conventional parallel imaging (factor 3) as well as CS (factor 7.7) acceleration at 3 T. Assessment: 4D flow MRI data were postprocessed by applying a valve tracking algorithm. Acquisition times, flow vol umes (mL/cycle) and diastolic function parameters (ratio of early to late diastolic left ventricular peak velocities [E/A] and ratio of early mitral inflow velocity to mitral annular early diastolic velocity [E/e0 ]) were quantified by two readers. Statistical Tests: Paired-samples t-test and Wilcoxon rank sum test to compare measurements. Pearson correlation coeffi cient (r), Bland–Altman-analysis (BA) and intraclass correlation coefficient (ICC) to evaluate agreement between techniques and readers. A P value < 0.05 was considered statistically significant. Results: A significant improvement in acquisition time was observed using CS vs. conventional accelerated acquisition (6.7 1.3 vs. 12.0 1.3 min). Net forward flow measurements for all valves showed good correlation (r > 0.81) and agree ment (ICCs > 0.89) between conventional and CS acceleration, with 3.3%–8.3% underestimation by the CS technique. Evaluation of diastolic function showed 3.2%–17.6% error: E/A 2.2 [1.9–2.4] (conventional) vs. 2.3 [2.0–2.6] (CS), BA bias 0.08 [ 0.81–0.96], ICC 0.82; and E/e0 4.6 [3.9–5.4] (conventional) vs. 3.8 [3.4–4.3] (CS), BA bias 0.90 [ 2.31–0.50], ICC 0.89. Data Conclusion: Analysis of intracardiac flow patterns and evaluation of diastolic function using a highly accelerated 4D flow sequence prototype is feasible, but it shows underestimation of flow measurements by approximately 10%. Evidence Level: 2 Technical Efficacy: Stage 1
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8539
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY-NC-ND
Information on rights of use:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Journal:	Journal of magnetic resonance imaging Version of Record (VoR)
Publisher:	Wiley-Liss
Publisher place:	New York, NY
Issue date:	2022
ISSN:	1522-2586
Publisher DOI:	10.1002/jmri.28484
Appears in collections:	DFG-491381577-H