Document Detail


Flow-sensitive four-dimensional magnetic resonance imaging: flow patterns in ascending aortic aneurysms.
MedLine Citation:
PMID:  18515137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pathological aortic flow patterns differ significantly from haemodynamics within the healthy aorta. Development and impact of pathological flow is largely unknown and might affect pathogenesis and the progression of thoracic aortic diseases. This study presents pathological blood-flow patterns within a series of six patients suffering from ascending aortic aneurysms investigated with high-detail flow-sensitive, four-dimensional (4D)-MRI and three-dimensional (3D) computer-aided flow-visualisation strategies. METHODS: Data were acquired on a 3T magnetic resonance system (TRIO, Siemens, Erlangen, Germany) using a flow-sensitive 4D (time-resolved 3D) sequence protocol. Measurements were taken in synchrony with the cardiac cycle and under respiration control. After data pre-processing, blood-flow was visualised by means of systolic 3D streamlines and time-resolved 3D particle traces using the software EnSight (CEI, Apex, NC, USA) and homemade visualisation tools. We investigated six adult patients with ascending aortic aneurysms and one healthy individual and findings were compared to 3D-haemodynamics of the dilated ascending aorta described in current literature. RESULTS: Normal blood-flow in the healthy volunteer resulted in highest velocities of up to 1 ms in the ascending and descending aorta, a right-handed helical flow pattern featuring 0.5-1.5 revolutions within the ascending aorta was present. Two atherosclerotic aneurysms presented either increased right-handed helical flow with flow acceleration along the great curvature, or multiple vortical flows in the sinuses and middle of the ascending aorta. One Marfan-associated aneurysm exhibited increased vortical flow in the dilated sinuses. One pseudo-aneurysm at the proximal anastomosis of an earlier supracoronary aortic replacement showed extensive vortex formation inside the aneurysm's lumen. An aneurysm in a patient with a bicuspid aortic valve revealed one major vortex formation directly above the aortic valve. One aneurysm following congenital valvular stenosis and commissurotomy in childhood was characterised by helical diastolic backflow in the central ascending aorta and a vortex at the small curvature. CONCLUSION: Patients with ascending aortic aneurysms reveal considerable differences in local flow patterns among themselves and compared to healthy individuals. Further investigations are necessary to identify flow patterns predisposing to aortic aneurysm development or adverse events in the course of aortic disease.
Authors:
Ernst Weigang; Fabian A Kari; Friedhelm Beyersdorf; Maximilian Luehr; Christian D Etz; Alex Frydrychowicz; Andreas Harloff; Michael Markl
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Publication Detail:
Type:  Journal Article     Date:  2008-06-02
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  34     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  11-6     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany. ernst.weigang@web.de <ernst.weigang@web.de>
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, False / physiopathology
Aorta / physiopathology*
Aortic Aneurysm / physiopathology*
Blood Flow Velocity
Female
Humans
Image Interpretation, Computer-Assisted / methods
Imaging, Three-Dimensional / methods
Magnetic Resonance Imaging / methods
Male
Marfan Syndrome / physiopathology
Middle Aged
Regional Blood Flow

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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