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Hemodynamic analysis of human vessels using three dimensional cine phase contrast magnetic resonance imaging (Hemodynamic assessments of human using 4D Flow)

Hemodynamic assessments of human using 4D Flow (Hemodynamic assessments of human using 4D Flow)

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Seventeen individuals had abdominal aortic disease (such as abdominal aortic aneurysms), 9 had thoracic aortic disease (including aortic dissection and aortic valve disorders), 51 were preoperative patients with cholangiocarcinoma undergoing PTPE (percutaneous transhepatic portal embolization), 20 were living liver donors, and 62 were related to portal hypertension, portosystemic shunts, liver transplant recipients, cirrhosis, hepatocellular carcinoma, among others.

The pace of enrollment was slower than initially anticipated, failing to meet the target number of 400 cases. This was significantly impacted by extended medical leaves of absence taken by co-investigators and prolonged de facto interruptions of the study due to the COVID-19 pandemic.

No adverse events or worsening of conditions were reported among the study participants.

We introduce two research papers have been published based on the data collected in this project. The first paper titled "Increased regional energy loss in spindle-shaped abdominal aortic aneurysms after endovascular aneurysm repair: evaluation by 4D flow MRI" discusses the evaluation of 13 consecutive patients who underwent endovascular aneurysm repair (EVAR) as the initial treatment for spindle-shaped abdominal aortic aneurysm (AAA). The mean velocity and local energy loss (EL) were compared before and after the procedure using 4D flow MRI. The study found that the mean velocity of AAA increased by 5-fold after EVAR and the total EL increased by 1.7-fold. The total EL was proportional to the AAA neck angle before and after EVAR, and BNP levels were proportional to total EL after EVAR. Patients were categorized into a deformed SG group and a non-deformed SG group, and BNP was compared before and after EVAR in each group. The study concludes that local EL in spindle-shaped abdominal aortic aneurysms increased after endovascular aneurysm repair, and the greater increase in EL in the variant SG group may be a potential concern for frail patients. The second paper titled "4D flow MRI evaluation of portal vein perfusion and liver regeneration after portal vein embolization" evaluated whether 4D flow MRI flowmetry can be used to estimate future liver remnant (FLR) capacity and identify the optimal timing of this measurement in patients with biliary tract cancer who underwent percutaneous transhepatic portal vein embolization (PVE) to the right liver. The study enrolled consecutive adult patients between June 2020 and November 2022, and portal vein hemodynamics were assessed using 4D flow MRI before PVE and within 1 day (0-day group) or 3-4 days (3-day group) after PVE. The study found that both groups had increased left portal vein (LPV) flow after PVE, and LPV flow change correlated with FLR volume change only in the 3-day group. The output of the regression equation for estimating preoperative FLR volume correlated with the volume measured by CT, and the study concludes that 4D flow MRI can be used to estimate FLR capacity and provide insight for estimating preoperative FLR volume.

Abnormal blood flow promotes vascular wall remodeling as endothelial cells act as mechanoreceptors, sensing wall shear stress and its fluctuations as signals, sometimes leading to pathological conditions. By using three-dimensional cine phase contrast methods, which provide time-varying three-dimensional velocity data, velocity and flow rate are measured, and derived parameters are calculated. This has yielded results that contribute to disease diagnosis, pathological evaluation, therapeutic efficacy determ

Mar. 31, 2024

Mar. 31, 2021

https://pubmed.ncbi.nlm.nih.gov/33434371/

No

NA

https://jrct.mhlw.go.jp/latest-detail/jRCTs041180157

Takehara Yasuo

Nagoya university hospital

65 Tsurumai-cho, Shouwa-ku, Nagoya, Aichi-ken

takehara@med.nagoya-u.ac.jp

Takehara Yasuo

Nagoya university graduate school of medicine

65 Tsurumai-cho, Shouwa-ku, Nagoya, Aichi-ken

+81-52-744-2327

takehara@med.nagoya-u.ac.jp

Complete

June. 25, 2018

Interventional

non-randomized controlled trial

open(masking not used)

no treatment control/standard of care control

parallel assignment

diagnostic purpose

candidate for abdominal magnetic resonance imaging.

contraindicated patients for magnetic resonance or contrast administration

Both

cardiovascular abnormalities

using MR contrast media

cardiovascular abnormalities

magnetic resonance, flow analysis, phase contrast image, wall shear stress

cardiovascular abnormalities/D018376

Diagnostic Uses of Chemicals/D064907

The relationship of hemodynamic abnormalities detected by flow velocity, wall shear stress, gradient oscillatory number, etc. derived from 3D cine phase contrast image and various cardiovascular diseases such as arteriosclerosis and perfusion abnormalities.

Hemodynamic analysis using 4D flow for organ perfusion before and after the stent graft placement for the aneurysm.

+81-52-744-2479

Jan. 23, 2019

none