Caval to pulmonary 3D flow distribution in patients with Fontan circulation and impact of potential 4D flow MRI error sources.


Journal

Magnetic resonance in medicine
ISSN: 1522-2594
Titre abrégé: Magn Reson Med
Pays: United States
ID NLM: 8505245

Informations de publication

Date de publication:
02 2019
Historique:
received: 15 02 2017
revised: 07 06 2018
accepted: 26 06 2018
pubmed: 3 10 2018
medline: 18 12 2019
entrez: 3 10 2018
Statut: ppublish

Résumé

Uneven flow distribution in patients with Fontan circulation is suspected to lead to complications. 4D flow MRI offers evaluation using time-resolved pathlines; however, the potential error is not well understood. The aim of this study was to systematically assess variability in flow distribution caused by well-known sources of error. 4D flow MRI was acquired in 14 patients with Fontan circulation. Flow distribution was quantified by the % of caval venous flow pathlines reaching the left and right pulmonary arteries. Impact of data acquisition and data processing uncertainties were investigated by (1) probabilistic 4D blood flow tracking at varying noise levels, (2) down-sampling to mimic acquisition at different spatial resolutions, (3) pathline calculation with and without eddy current correction, and (4) varied segmentation of the Fontan geometry to mimic analysis errors. Averaged among the cohort, uncertainties accounted for flow distribution errors from noise ≤3.2%, low spatial resolution ≤2.3% to 3.8%, eddy currents ≤6.4%, and inaccurate segmentation ≤3.9% to 9.1% (dilation and erosion, respectively). In a worst-case scenario (maximum additive errors for all 4 sources), flow distribution errors were as high as 22.5%. Inaccuracies related to postprocessing (segmentation, eddy currents) resulted in the largest potential error (≤15.5% combined) whereas errors related to data acquisition (noise, low spatial resolution) had a lower impact (≤5.5%-7.0% combined). Whereas it is unlikely that these errors will be additive or affect the identification of severe asymmetry, these results illustrate the importance of eddy current correction and accurate segmentation to minimize Fontan flow distribution errors.

Identifiants

pubmed: 30277276
doi: 10.1002/mrm.27455
pmc: PMC6289652
mid: NIHMS978897
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1205-1218

Subventions

Organisme : National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI)
ID : T32HL134633
Pays : International
Organisme : National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI)
ID : K25HL119608
Pays : International
Organisme : NHLBI NIH HHS
ID : K25 HL119608
Pays : United States
Organisme : National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI)
ID : R01HL115828
Pays : International
Organisme : NHLBI NIH HHS
ID : R01 HL115828
Pays : United States
Organisme : National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI)
ID : (T32HL134633, R01HL115828, K25HL119608)
Pays : International
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL134633
Pays : United States

Informations de copyright

© 2018 International Society for Magnetic Resonance in Medicine.

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Auteurs

Kelly Jarvis (K)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Illinois.

Susanne Schnell (S)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Alex J Barker (AJ)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Michael Rose (M)

Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Joshua D Robinson (JD)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Cynthia K Rigsby (CK)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Michael Markl (M)

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Illinois.

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