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Published in: Current Cardiovascular Imaging Reports 2/2013

01-04-2013 | Cardiac Magnetic Resonance (E Nagel, Section Editor)

Clinical Applications of Aortic 4D Flow Imaging

Authors: Michael D. Hope, S. Jarrett Wrenn, Petter Dyverfeldt

Published in: Current Cardiovascular Imaging Reports | Issue 2/2013

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Abstract

Quantitative aortic magnetic resonance (MR) blood flow imaging is a rapidly advancing technique that is likely to impact clinical medicine in the near future. The acquisition of comprehensive 4D velocity datasets is now possible in a clinically acceptable time frame. Unique and intuitive visualization methods are available. A number of important hemodynamic biomarkers can be derived from the data, and exploited to help understand how abnormal flow is inter-related with aortic pathology. Initial data suggest that some of the derived biomarkers can refine the clinical assessment of aortic disease and predict disease progression. We provide an overview of aortic imaging with emphasis on how flow imaging is currently used, discuss the fundamental technical aspects of multidimensional MR flow imaging, introduce key hemodynamic markers, and show how this type of imaging may soon be used for the early identification of patients at risk for the development of potentially devastating aortic complications.
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Literature
1.
go back to reference Elefteriades JA, Farkas EA. Thoracic aortic aneurysm clinically pertinent controversies and uncertainties. J Am Coll Cardiol. 2010;55:841–57.PubMedCrossRef Elefteriades JA, Farkas EA. Thoracic aortic aneurysm clinically pertinent controversies and uncertainties. J Am Coll Cardiol. 2010;55:841–57.PubMedCrossRef
2.
go back to reference Scott RA, Ashton HA, Kay DN. Abdominal aortic aneurysm in 4237 screened patients: prevalence, development, and management over 6 years. Br J Surg. 1991;78:1122–5.PubMedCrossRef Scott RA, Ashton HA, Kay DN. Abdominal aortic aneurysm in 4237 screened patients: prevalence, development, and management over 6 years. Br J Surg. 1991;78:1122–5.PubMedCrossRef
4.
go back to reference Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey Jr DE, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121:e266–369.PubMedCrossRef Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey Jr DE, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121:e266–369.PubMedCrossRef
5.
go back to reference Brown LC, Powell JT. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance.UK small aneurysm trial participants. Ann Surg. 1999;230:289–96. discussion 296–87.PubMedCrossRef Brown LC, Powell JT. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance.UK small aneurysm trial participants. Ann Surg. 1999;230:289–96. discussion 296–87.PubMedCrossRef
6.
go back to reference Elefteriades JA. Thoracic aortic aneurysm: reading the enemy's playbook. Curr Probl Cardiol. 2008;33:203–77.PubMedCrossRef Elefteriades JA. Thoracic aortic aneurysm: reading the enemy's playbook. Curr Probl Cardiol. 2008;33:203–77.PubMedCrossRef
7.
go back to reference Fillinger MF, Marra SP, Raghavan ML, Kennedy FE. Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J Vasc Surg. 2003;37:724–32.PubMedCrossRef Fillinger MF, Marra SP, Raghavan ML, Kennedy FE. Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J Vasc Surg. 2003;37:724–32.PubMedCrossRef
8.
go back to reference Nicholls SC, Gardner JB, Meissner MH, Johansen HK. Rupture in small abdominal aortic aneurysms. J Vasc Surg. 1998;28:884–8.PubMedCrossRef Nicholls SC, Gardner JB, Meissner MH, Johansen HK. Rupture in small abdominal aortic aneurysms. J Vasc Surg. 1998;28:884–8.PubMedCrossRef
9.
go back to reference Pape LA, Tsai TT, Isselbacher EM, Oh JK, O'Gara PT, Evangelista A, et al. Aortic diameter > or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2007;116:1120–7.PubMedCrossRef Pape LA, Tsai TT, Isselbacher EM, Oh JK, O'Gara PT, Evangelista A, et al. Aortic diameter > or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2007;116:1120–7.PubMedCrossRef
10.
go back to reference Hope TA, Hope MD. Improved risk assessment for abdominal aortic aneurysm rupture off-the-wall imaging. J Am Coll Cardiol. 2011;58:2531–2.PubMedCrossRef Hope TA, Hope MD. Improved risk assessment for abdominal aortic aneurysm rupture off-the-wall imaging. J Am Coll Cardiol. 2011;58:2531–2.PubMedCrossRef
11.
12.
go back to reference Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA. 1999;282:2035–42.PubMedCrossRef Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA. 1999;282:2035–42.PubMedCrossRef
14.
go back to reference Hope MD, Hope TA, Crook SE, Ordovas KG, Urbania TH, Alley MT, et al. 4D Flow CMR in assessment of valve-related ascending aortic disease. JACC Cardiovasc Imaging. 2011;4:781–7.PubMedCrossRef Hope MD, Hope TA, Crook SE, Ordovas KG, Urbania TH, Alley MT, et al. 4D Flow CMR in assessment of valve-related ascending aortic disease. JACC Cardiovasc Imaging. 2011;4:781–7.PubMedCrossRef
15.
go back to reference Rayz VL, Boussel L, Ge L, Leach JR, Martin AJ, Lawton MT, et al. Flow residence time and regions of intraluminal thrombus deposition in intracranial aneurysms. Ann Biomed Eng. 2010;38:3058–69. Rayz VL, Boussel L, Ge L, Leach JR, Martin AJ, Lawton MT, et al. Flow residence time and regions of intraluminal thrombus deposition in intracranial aneurysms. Ann Biomed Eng. 2010;38:3058–69.
16.
go back to reference Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, et al. Clinical indications for cardiovascular magnetic resonance (CMR): consensus Panel report. Eur Heart J. 2004;25:1940–65.PubMedCrossRef Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, et al. Clinical indications for cardiovascular magnetic resonance (CMR): consensus Panel report. Eur Heart J. 2004;25:1940–65.PubMedCrossRef
17.
go back to reference Glockner JF, Johnston DL, McGee KP. Evaluation of cardiac valvular disease with MR imaging: qualitative and quantitative techniques. Radiographics. 2003;23:e9.PubMedCrossRef Glockner JF, Johnston DL, McGee KP. Evaluation of cardiac valvular disease with MR imaging: qualitative and quantitative techniques. Radiographics. 2003;23:e9.PubMedCrossRef
18.
go back to reference Cawley PJ, Maki JH, Otto CM. Cardiovascular magnetic resonance imaging for valvular heart disease: technique and validation. Circulation. 2009;119:468–78.PubMedCrossRef Cawley PJ, Maki JH, Otto CM. Cardiovascular magnetic resonance imaging for valvular heart disease: technique and validation. Circulation. 2009;119:468–78.PubMedCrossRef
19.
go back to reference Garcia J, Marrufo OR, Rodriguez AO, Larose E, Pibarot P, Kadem L. Cardiovascular magnetic resonance evaluation of aortic stenosis severity using single plane measurement of effective orifice area. J Cardiovasc Magn Reson. 2012;14:23.PubMedCrossRef Garcia J, Marrufo OR, Rodriguez AO, Larose E, Pibarot P, Kadem L. Cardiovascular magnetic resonance evaluation of aortic stenosis severity using single plane measurement of effective orifice area. J Cardiovasc Magn Reson. 2012;14:23.PubMedCrossRef
20.
go back to reference Kilner PJ, Manzara CC, Mohiaddin RH, Pennell DJ, Sutton MG, Firmin DN, et al. Magnetic resonance jet velocity mapping in mitral and aortic valve stenosis. Circulation. 1993;87:1239–48.PubMedCrossRef Kilner PJ, Manzara CC, Mohiaddin RH, Pennell DJ, Sutton MG, Firmin DN, et al. Magnetic resonance jet velocity mapping in mitral and aortic valve stenosis. Circulation. 1993;87:1239–48.PubMedCrossRef
21.
go back to reference Nielsen JC, Powell AJ, Gauvreau K, Marcus EN, Prakash A, Geva T. Magnetic resonance imaging predictors of coarctation severity. Circulation. 2005;111:622–8.PubMedCrossRef Nielsen JC, Powell AJ, Gauvreau K, Marcus EN, Prakash A, Geva T. Magnetic resonance imaging predictors of coarctation severity. Circulation. 2005;111:622–8.PubMedCrossRef
22.
go back to reference Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:e714–833.PubMedCrossRef Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, et al. ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:e714–833.PubMedCrossRef
23.
go back to reference Muzzarelli S, Meadows AK, Ordovas KG, Higgins CB, Meadows JJ. Usefulness of cardiovascular magnetic resonance imaging to predict the need for intervention in patients with coarctation of the aorta. Am J Cardiol. 2012;109:861–5.PubMedCrossRef Muzzarelli S, Meadows AK, Ordovas KG, Higgins CB, Meadows JJ. Usefulness of cardiovascular magnetic resonance imaging to predict the need for intervention in patients with coarctation of the aorta. Am J Cardiol. 2012;109:861–5.PubMedCrossRef
24.
go back to reference Steffens JC, Bourne MW, Sakuma H, O'Sullivan M, Higgins CB. Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging. Circulation. 1994;90:937–43.PubMedCrossRef Steffens JC, Bourne MW, Sakuma H, O'Sullivan M, Higgins CB. Quantification of collateral blood flow in coarctation of the aorta by velocity encoded cine magnetic resonance imaging. Circulation. 1994;90:937–43.PubMedCrossRef
25.
go back to reference Araoz PA, Reddy GP, Tarnoff H, Roge CL, Higgins CB. MR findings of collateral circulation are more accurate measures of hemodynamic significance than arm-leg blood pressure gradient after repair of coarctation of the aorta. J Magn Reson Imaging. 2003;17:177–83.PubMedCrossRef Araoz PA, Reddy GP, Tarnoff H, Roge CL, Higgins CB. MR findings of collateral circulation are more accurate measures of hemodynamic significance than arm-leg blood pressure gradient after repair of coarctation of the aorta. J Magn Reson Imaging. 2003;17:177–83.PubMedCrossRef
26.
go back to reference Muzzarelli S, Ordovas KG, Hope MD, Meadows JJ, Higgins CB, Meadows AK. Diagnostic value of the flow profile in the distal descending aorta by phase-contrast magnetic resonance for predicting severe coarctation of the aorta. J Magn Reson Imaging. 2011;33:1440–6.PubMedCrossRef Muzzarelli S, Ordovas KG, Hope MD, Meadows JJ, Higgins CB, Meadows AK. Diagnostic value of the flow profile in the distal descending aorta by phase-contrast magnetic resonance for predicting severe coarctation of the aorta. J Magn Reson Imaging. 2011;33:1440–6.PubMedCrossRef
27.
go back to reference Pelc NJ, Bernstein MA, Shimakawa A, Glover GH. Encoding strategies for 3-direction phase-contrast MR imaging of flow. J Magn Reson Imaging. 1991;1:405–13.PubMedCrossRef Pelc NJ, Bernstein MA, Shimakawa A, Glover GH. Encoding strategies for 3-direction phase-contrast MR imaging of flow. J Magn Reson Imaging. 1991;1:405–13.PubMedCrossRef
28.
go back to reference •• Knobloch V, Boesiger P, Kozerke S. Sparsity transform k-t principal component analysis for accelerating cine 3-dimensional flow measurements. Magn Reson Med. 2012. doi:10.1002/mrm.24431. New reconstruction techniques allow acceleration factors of up to 8 to be used with preservation of data quality. •• Knobloch V, Boesiger P, Kozerke S. Sparsity transform k-t principal component analysis for accelerating cine 3-dimensional flow measurements. Magn Reson Med. 2012. doi:10.​1002/​mrm.​24431. New reconstruction techniques allow acceleration factors of up to 8 to be used with preservation of data quality.
29.
go back to reference •• Hsiao A, Lustig M, Alley MT, Murphy M, Chan FP, Herfkens RJ, et al. Rapid pediatric cardiac assessment of flow and ventricular volume with compressed sensing parallel imaging volumetric cine phase-contrast MRI. Am J Roentgenol. 2012;198:W250–9. Accelerated 4D Flow with compressed sensing is validated in a clinical setting with direct comparison to standard 2D PC-MRI data.CrossRef •• Hsiao A, Lustig M, Alley MT, Murphy M, Chan FP, Herfkens RJ, et al. Rapid pediatric cardiac assessment of flow and ventricular volume with compressed sensing parallel imaging volumetric cine phase-contrast MRI. Am J Roentgenol. 2012;198:W250–9. Accelerated 4D Flow with compressed sensing is validated in a clinical setting with direct comparison to standard 2D PC-MRI data.CrossRef
30.
go back to reference Gu T, Korosec FR, Block WF, Fain SB, Turk Q, Lum D, et al. PC VIPR: a high-speed 3D phase-contrast method for flow quantification and high-resolution angiography. Am J Neuroradiol. 2005;26:743–9.PubMed Gu T, Korosec FR, Block WF, Fain SB, Turk Q, Lum D, et al. PC VIPR: a high-speed 3D phase-contrast method for flow quantification and high-resolution angiography. Am J Neuroradiol. 2005;26:743–9.PubMed
31.
go back to reference • Sigfridsson A, Petersson S, Carlhall CJ, Ebbers T. Four-dimensional flow MRI using spiral acquisition. Magn Reson Med. 2012;68:1065–73. A new 4D Flow sequence with a non-Cartesian k-space trajectory (spiral) permits 3 times faster acquisition of data.PubMedCrossRef • Sigfridsson A, Petersson S, Carlhall CJ, Ebbers T. Four-dimensional flow MRI using spiral acquisition. Magn Reson Med. 2012;68:1065–73. A new 4D Flow sequence with a non-Cartesian k-space trajectory (spiral) permits 3 times faster acquisition of data.PubMedCrossRef
32.
go back to reference Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, et al. Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012;5:305–16.PubMedCrossRef Sengupta PP, Pedrizzetti G, Kilner PJ, Kheradvar A, Ebbers T, Tonti G, et al. Emerging trends in CV flow visualization. JACC Cardiovasc Imaging. 2012;5:305–16.PubMedCrossRef
33.
go back to reference Buonocore MH. Visualizing blood flow patterns using streamlines, arrows, and particle paths. Magn Reson Med. 1998;40:210–26.PubMedCrossRef Buonocore MH. Visualizing blood flow patterns using streamlines, arrows, and particle paths. Magn Reson Med. 1998;40:210–26.PubMedCrossRef
34.
go back to reference • Harloff A, Simon J, Brendecke S, Assefa D, Helbing T, Frydrychowicz A, et al. Complex plaques in the proximal descending aorta: an underestimated embolic source of stroke. Stroke. 2010;41:1145–50. A previously unappreciated source of stroke is identified based on 4D Flow visualization of retrograde flow in the descending aorta.PubMedCrossRef • Harloff A, Simon J, Brendecke S, Assefa D, Helbing T, Frydrychowicz A, et al. Complex plaques in the proximal descending aorta: an underestimated embolic source of stroke. Stroke. 2010;41:1145–50. A previously unappreciated source of stroke is identified based on 4D Flow visualization of retrograde flow in the descending aorta.PubMedCrossRef
35.
go back to reference Eriksson J, Carlhall CJ, Dyverfeldt P, Engvall J, Bolger AF, Ebbers T. Semi-automatic quantification of 4D left ventricular blood flow. J Cardiovasc Magn Reson. 2010;12:9. doi:10.1186/1532-429X-12-9. Eriksson J, Carlhall CJ, Dyverfeldt P, Engvall J, Bolger AF, Ebbers T. Semi-automatic quantification of 4D left ventricular blood flow. J Cardiovasc Magn Reson. 2010;12:9. doi:10.​1186/​1532-429X-12-9.
36.
go back to reference Hope TA, Markl M, Wigstrom L, Alley MT, Miller DC, Herfkens RJ. Comparison of flow patterns in ascending aortic aneurysms and volunteers using 4-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging. 2007;26:1471–9.PubMedCrossRef Hope TA, Markl M, Wigstrom L, Alley MT, Miller DC, Herfkens RJ. Comparison of flow patterns in ascending aortic aneurysms and volunteers using 4-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging. 2007;26:1471–9.PubMedCrossRef
37.
go back to reference •• Clough RE, Waltham M, Giese D, Taylor PR, Schaeffter T. A new imaging method for assessment of aortic dissection using 4-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 2012;55:914–23. Abnormal blood flow characteristics including helicity are correlated with disease progression in a cohort of patients with chronic type B aortic dissection.PubMedCrossRef •• Clough RE, Waltham M, Giese D, Taylor PR, Schaeffter T. A new imaging method for assessment of aortic dissection using 4-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 2012;55:914–23. Abnormal blood flow characteristics including helicity are correlated with disease progression in a cohort of patients with chronic type B aortic dissection.PubMedCrossRef
38.
go back to reference • Sigovan M, Hope MD, Dyverfeldt P, Saloner D. Comparison of 4-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta. J Magn Reson Imaging. 2011;34:1226–30. A straightforward and reproducible hemodynamic parameter is presented that may outperform more complicated estimates of abnormal blood flow.PubMedCrossRef • Sigovan M, Hope MD, Dyverfeldt P, Saloner D. Comparison of 4-dimensional flow parameters for quantification of flow eccentricity in the ascending aorta. J Magn Reson Imaging. 2011;34:1226–30. A straightforward and reproducible hemodynamic parameter is presented that may outperform more complicated estimates of abnormal blood flow.PubMedCrossRef
39.
go back to reference • Rolf MP, Hofman MB, Gatehouse PD, Markenroth-Bloch K, Heymans MW, Ebbers T, et al. Sequence optimization to reduce velocity offsets in cardiovascular magnetic resonance volume flow quantification–a multi-vendor study. J Cardiovasc Magn Reson. 2011;13:18. The effects of background phase offsets in phase-contrast MRI are systematically evaluated.PubMedCrossRef • Rolf MP, Hofman MB, Gatehouse PD, Markenroth-Bloch K, Heymans MW, Ebbers T, et al. Sequence optimization to reduce velocity offsets in cardiovascular magnetic resonance volume flow quantification–a multi-vendor study. J Cardiovasc Magn Reson. 2011;13:18. The effects of background phase offsets in phase-contrast MRI are systematically evaluated.PubMedCrossRef
40.
go back to reference Boussel L, Rayz V, Martin A, Acevedo-Bolton G, Lawton MT, Higashida R, et al. Phase-contrast magnetic resonance imaging measurements in intracranial aneurysms in vivo of flow patterns, velocity fields, and wall shear stress: comparison with computational fluid dynamics. Magn Reson Med. 2009;61:409–17.PubMedCrossRef Boussel L, Rayz V, Martin A, Acevedo-Bolton G, Lawton MT, Higashida R, et al. Phase-contrast magnetic resonance imaging measurements in intracranial aneurysms in vivo of flow patterns, velocity fields, and wall shear stress: comparison with computational fluid dynamics. Magn Reson Med. 2009;61:409–17.PubMedCrossRef
41.
go back to reference Petersson S, Dyverfeldt P, Gardhagen R, Karlsson M, Ebbers T. Simulation of phase contrast MRI of turbulent flow. Magn Reson Med. 2010;64:1039–46.PubMedCrossRef Petersson S, Dyverfeldt P, Gardhagen R, Karlsson M, Ebbers T. Simulation of phase contrast MRI of turbulent flow. Magn Reson Med. 2010;64:1039–46.PubMedCrossRef
42.
go back to reference • Eriksson J, Carlhall CJ, Dyverfeldt P, Engvall J, Bolger AF, Ebbers T. Semi-automatic quantification of 4D left ventricular blood flow. J Cardiovasc Magn Reson. 2010;12:9. An inclusive and robust approach to internal validation of 4D Flow velocity data is presented.PubMedCrossRef • Eriksson J, Carlhall CJ, Dyverfeldt P, Engvall J, Bolger AF, Ebbers T. Semi-automatic quantification of 4D left ventricular blood flow. J Cardiovasc Magn Reson. 2010;12:9. An inclusive and robust approach to internal validation of 4D Flow velocity data is presented.PubMedCrossRef
43.
go back to reference Roes SD, Hammer S, van der Geest RJ, Marsan NA, Bax JJ, Lamb HJ, et al. Flow assessment through 4 heart valves simultaneously using 3-dimensional 3-directional velocity-encoded magnetic resonance imaging with retrospective valve tracking in healthy volunteers and patients with valvular regurgitation. Invest Radiol. 2009;44:669–75.PubMedCrossRef Roes SD, Hammer S, van der Geest RJ, Marsan NA, Bax JJ, Lamb HJ, et al. Flow assessment through 4 heart valves simultaneously using 3-dimensional 3-directional velocity-encoded magnetic resonance imaging with retrospective valve tracking in healthy volunteers and patients with valvular regurgitation. Invest Radiol. 2009;44:669–75.PubMedCrossRef
44.
go back to reference •• Hope MD, Meadows AK, Hope TA, Ordovas KG, Saloner D, Reddy GP, et al. A clinical evaluation of aortic coarctation with 4D Flow MR imaging. J Magn Reson Imaging. 2010;31:711–8. 4D Flow is incorporated into the clinical scheme for evaluating aortic coarctation and shown to be reliable.PubMedCrossRef •• Hope MD, Meadows AK, Hope TA, Ordovas KG, Saloner D, Reddy GP, et al. A clinical evaluation of aortic coarctation with 4D Flow MR imaging. J Magn Reson Imaging. 2010;31:711–8. 4D Flow is incorporated into the clinical scheme for evaluating aortic coarctation and shown to be reliable.PubMedCrossRef
45.
go back to reference •• Valverde I, Nordmeyer S, Uribe S, Greil G, Berger F, Kuehne T, et al. Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition. J Cardiovasc Magn Reson. 2012;14:25. The value of a comprehensive evaluation of complex congenital cardiac physiology with a single 4D Flow acquisition is clearly presented. •• Valverde I, Nordmeyer S, Uribe S, Greil G, Berger F, Kuehne T, et al. Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition. J Cardiovasc Magn Reson. 2012;14:25. The value of a comprehensive evaluation of complex congenital cardiac physiology with a single 4D Flow acquisition is clearly presented.
46.
go back to reference Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011;57:1511–22.PubMedCrossRef Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011;57:1511–22.PubMedCrossRef
47.
go back to reference Tzemos N, Lyseggen E, Silversides C, Jamorski M, Tong JH, Harvey P, et al. Endothelial function, carotid-femoral stiffness, and plasma matrix metalloproteinase-2 in men with bicuspid aortic valve and dilated aorta. J Am Coll Cardiol. 2010;55:660–8.PubMedCrossRef Tzemos N, Lyseggen E, Silversides C, Jamorski M, Tong JH, Harvey P, et al. Endothelial function, carotid-femoral stiffness, and plasma matrix metalloproteinase-2 in men with bicuspid aortic valve and dilated aorta. J Am Coll Cardiol. 2010;55:660–8.PubMedCrossRef
48.
go back to reference Nollen GJ, Groenink M, Tijssen JG, Van Der Wall EE, Mulder BJ. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome. Eur Heart J. 2004;25:1146–52.PubMedCrossRef Nollen GJ, Groenink M, Tijssen JG, Van Der Wall EE, Mulder BJ. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome. Eur Heart J. 2004;25:1146–52.PubMedCrossRef
49.
go back to reference Ahimastos AA, Aggarwal A, D'Orsa KM, Formosa MF, White AJ, Savarirayan R, et al. Effect of perindopril on large artery stiffness and aortic root diameter in patients with Marfan syndrome: a randomized controlled trial. JAMA. 2007;298:1539–47.PubMedCrossRef Ahimastos AA, Aggarwal A, D'Orsa KM, Formosa MF, White AJ, Savarirayan R, et al. Effect of perindopril on large artery stiffness and aortic root diameter in patients with Marfan syndrome: a randomized controlled trial. JAMA. 2007;298:1539–47.PubMedCrossRef
50.
go back to reference Groenink M, de Roos A, Mulder BJ, Spaan JA, van der Wall EE. Changes in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blocker therapy in the Marfan syndrome. Am J Cardiol. 1998;82:203–8.PubMedCrossRef Groenink M, de Roos A, Mulder BJ, Spaan JA, van der Wall EE. Changes in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blocker therapy in the Marfan syndrome. Am J Cardiol. 1998;82:203–8.PubMedCrossRef
51.
go back to reference Grotenhuis HB, Westenberg JJ, Steendijk P, van der Geest RJ, Ottenkamp J, Bax JJ, et al. Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging. 2009;30:521–6.PubMedCrossRef Grotenhuis HB, Westenberg JJ, Steendijk P, van der Geest RJ, Ottenkamp J, Bax JJ, et al. Validation and reproducibility of aortic pulse wave velocity as assessed with velocity-encoded MRI. J Magn Reson Imaging. 2009;30:521–6.PubMedCrossRef
52.
go back to reference Fielden SW, Fornwalt BK, Jerosch-Herold M, Eisner RL, Stillman AE, Oshinski JN. A new method for the determination of aortic pulse wave velocity using cross-correlation on 2D PCMR velocity data. J Magn Reson Imaging. 2008;27:1382–7.PubMedCrossRef Fielden SW, Fornwalt BK, Jerosch-Herold M, Eisner RL, Stillman AE, Oshinski JN. A new method for the determination of aortic pulse wave velocity using cross-correlation on 2D PCMR velocity data. J Magn Reson Imaging. 2008;27:1382–7.PubMedCrossRef
53.
go back to reference • Markl M, Wallis W, Brendecke S, Simon J, Frydrychowicz A, Harloff A. Estimation of global aortic pulse wave velocity by flow-sensitive 4D MRI. Magn Reson Med. 2010;63:1575–82. Global pulse wave velocity can be reliably measured with a cross-correlation technique using 4D Flow.PubMedCrossRef • Markl M, Wallis W, Brendecke S, Simon J, Frydrychowicz A, Harloff A. Estimation of global aortic pulse wave velocity by flow-sensitive 4D MRI. Magn Reson Med. 2010;63:1575–82. Global pulse wave velocity can be reliably measured with a cross-correlation technique using 4D Flow.PubMedCrossRef
54.
go back to reference Ebbers T, Wigstrom L, Bolger AF, Engvall J, Karlsson M. Estimation of relative cardiovascular pressures using time-resolved 3-dimensional phase contrast. Magn Reson Med. 2001;45:872–9.PubMedCrossRef Ebbers T, Wigstrom L, Bolger AF, Engvall J, Karlsson M. Estimation of relative cardiovascular pressures using time-resolved 3-dimensional phase contrast. Magn Reson Med. 2001;45:872–9.PubMedCrossRef
55.
go back to reference Bock J, Frydrychowicz A, Lorenz R, Hirtler D, Barker AJ, Johnson KM, et al. In vivo noninvasive 4D pressure difference mapping in the human aorta: phantom comparison and application in healthy volunteers and patients. Magn Reson Med. 2011;66:1079–88.PubMedCrossRef Bock J, Frydrychowicz A, Lorenz R, Hirtler D, Barker AJ, Johnson KM, et al. In vivo noninvasive 4D pressure difference mapping in the human aorta: phantom comparison and application in healthy volunteers and patients. Magn Reson Med. 2011;66:1079–88.PubMedCrossRef
56.
go back to reference Ebbers T, Wigstrom L, Bolger AF, Wranne B, Karlsson M. Noninvasive measurement of time-varying 3-dimensional relative pressure fields within the human heart. J Biomech Eng. 2002;124:288–93.PubMedCrossRef Ebbers T, Wigstrom L, Bolger AF, Wranne B, Karlsson M. Noninvasive measurement of time-varying 3-dimensional relative pressure fields within the human heart. J Biomech Eng. 2002;124:288–93.PubMedCrossRef
57.
go back to reference Tyszka JM, Laidlaw DH, Asa JW, Silverman JM. Three-dimensional, time-resolved (4D) relative pressure mapping using magnetic resonance imaging. J Magn Reson Imaging. 2000;12:321–9.PubMedCrossRef Tyszka JM, Laidlaw DH, Asa JW, Silverman JM. Three-dimensional, time-resolved (4D) relative pressure mapping using magnetic resonance imaging. J Magn Reson Imaging. 2000;12:321–9.PubMedCrossRef
58.
go back to reference Ebbers T, Farneback G. Improving computation of cardiovascular relative pressure fields from velocity MRI. J Magn Reson Imaging. 2009;30:54–61.PubMedCrossRef Ebbers T, Farneback G. Improving computation of cardiovascular relative pressure fields from velocity MRI. J Magn Reson Imaging. 2009;30:54–61.PubMedCrossRef
59.
go back to reference Dyverfeldt P, Sigfridsson A, Kvitting JP, Ebbers T. Quantification of intravoxel velocity standard deviation and turbulence intensity by generalizing phase-contrast MRI. Magn Reson Med. 2006;56:850–8.PubMedCrossRef Dyverfeldt P, Sigfridsson A, Kvitting JP, Ebbers T. Quantification of intravoxel velocity standard deviation and turbulence intensity by generalizing phase-contrast MRI. Magn Reson Med. 2006;56:850–8.PubMedCrossRef
60.
go back to reference Dyverfeldt P, Kvitting JP, Sigfridsson A, Engvall J, Bolger AF, Ebbers T. Assessment of fluctuating velocities in disturbed cardiovascular blood flow: in vivo feasibility of generalized phase-contrast MRI. J Magn Reson Imaging. 2008;28:655–63.PubMedCrossRef Dyverfeldt P, Kvitting JP, Sigfridsson A, Engvall J, Bolger AF, Ebbers T. Assessment of fluctuating velocities in disturbed cardiovascular blood flow: in vivo feasibility of generalized phase-contrast MRI. J Magn Reson Imaging. 2008;28:655–63.PubMedCrossRef
61.
go back to reference Elkins CJ, Alley MT, Saetran L, Eaton JK. Three-dimensional magnetic resonance velocimetry measurements of turbulence quantities in complex flow. Exp Fluids. 2009;46:285–96.CrossRef Elkins CJ, Alley MT, Saetran L, Eaton JK. Three-dimensional magnetic resonance velocimetry measurements of turbulence quantities in complex flow. Exp Fluids. 2009;46:285–96.CrossRef
62.
go back to reference Binter C, Knobloch V, Manka R, Sigfridsson A, Kozerke S. Bayesian multipoint velocity encoding for concurrent flow and turbulence mapping. Magn Reson Med. 2012. doi:10.1002/mrm.24370. Binter C, Knobloch V, Manka R, Sigfridsson A, Kozerke S. Bayesian multipoint velocity encoding for concurrent flow and turbulence mapping. Magn Reson Med. 2012. doi:10.​1002/​mrm.​24370.
63.
go back to reference •• Dyverfeldt P HM, Tseng EE, Saloner D. Noninvasive magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis. J Am Coll Cardiol Imaging. 2012 (in press). Noninvasive estimation of the irreversible pressure loss associated with a stenotic lesion. •• Dyverfeldt P HM, Tseng EE, Saloner D. Noninvasive magnetic resonance measurement of turbulent kinetic energy for the estimation of irreversible pressure loss in aortic stenosis. J Am Coll Cardiol Imaging. 2012 (in press). Noninvasive estimation of the irreversible pressure loss associated with a stenotic lesion.
64.
go back to reference Davies PF, Remuzzi A, Gordon EJ, Dewey Jr CF, Gimbrone Jr MA. Turbulent fluid shear stress induces vascular endothelial cell turnover in vitro. Proc Natl Acad Sci U S A. 1986;83:2114–7.PubMedCrossRef Davies PF, Remuzzi A, Gordon EJ, Dewey Jr CF, Gimbrone Jr MA. Turbulent fluid shear stress induces vascular endothelial cell turnover in vitro. Proc Natl Acad Sci U S A. 1986;83:2114–7.PubMedCrossRef
65.
go back to reference Sallam AM, Hwang NH. Human red blood cell hemolysis in a turbulent shear flow: contribution of Reynolds shear stresses. Biorheology. 1984;21:783–97.PubMed Sallam AM, Hwang NH. Human red blood cell hemolysis in a turbulent shear flow: contribution of Reynolds shear stresses. Biorheology. 1984;21:783–97.PubMed
66.
go back to reference Stein PD, Sabbah HN. Measured turbulence and its effect on thrombus formation. Circ Res. 1974;35:608–14.PubMedCrossRef Stein PD, Sabbah HN. Measured turbulence and its effect on thrombus formation. Circ Res. 1974;35:608–14.PubMedCrossRef
67.
go back to reference Barker AJ, Lanning C, Shandas R. Quantification of hemodynamic wall shear stress in patients with bicuspid aortic valve using phase-contrast MRI. Ann Biomed Eng. 2010;38:788–800.PubMedCrossRef Barker AJ, Lanning C, Shandas R. Quantification of hemodynamic wall shear stress in patients with bicuspid aortic valve using phase-contrast MRI. Ann Biomed Eng. 2010;38:788–800.PubMedCrossRef
68.
go back to reference Markl M, Wallis W, Harloff A. Reproducibility of flow and wall shear stress analysis using flow-sensitive 4-dimensional MRI. J Magn Reson Imaging. 2011;33:988–94.PubMedCrossRef Markl M, Wallis W, Harloff A. Reproducibility of flow and wall shear stress analysis using flow-sensitive 4-dimensional MRI. J Magn Reson Imaging. 2011;33:988–94.PubMedCrossRef
69.
go back to reference Bieging ET, Frydrychowicz A, Wentland A, Landgraf BR, Johnson KM, Wieben O, et al. In vivo 3-dimensional MR wall shear stress estimation in ascending aortic dilatation. J Magn Reson Imaging. 2011;33:589–97.CrossRef Bieging ET, Frydrychowicz A, Wentland A, Landgraf BR, Johnson KM, Wieben O, et al. In vivo 3-dimensional MR wall shear stress estimation in ascending aortic dilatation. J Magn Reson Imaging. 2011;33:589–97.CrossRef
70.
go back to reference Stalder AF, Russe MF, Frydrychowicz A, Bock J, Hennig J, Markl M. Quantitative 2D and 3D phase contrast MRI: optimized analysis of blood flow and vessel wall parameters. Magn Reson Med. 2008;60:1218–31.PubMedCrossRef Stalder AF, Russe MF, Frydrychowicz A, Bock J, Hennig J, Markl M. Quantitative 2D and 3D phase contrast MRI: optimized analysis of blood flow and vessel wall parameters. Magn Reson Med. 2008;60:1218–31.PubMedCrossRef
71.
go back to reference • Petersson S, Dyverfeldt P, Ebbers T. Assessment of the accuracy of MRI wall shear stress estimation using numerical simulations. J Magn Reson Imaging. 2012;36:128–38. Detailed investigation of pitfalls and limitations of MR-based WSS estimation.PubMedCrossRef • Petersson S, Dyverfeldt P, Ebbers T. Assessment of the accuracy of MRI wall shear stress estimation using numerical simulations. J Magn Reson Imaging. 2012;36:128–38. Detailed investigation of pitfalls and limitations of MR-based WSS estimation.PubMedCrossRef
72.
go back to reference Barker AJ, Markl M, Burk J, Lorenz R, Bock J, Bauer S, et al. Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta. Circ Cardiovasc Imaging. 2012;5:457–66. Barker AJ, Markl M, Burk J, Lorenz R, Bock J, Bauer S, et al. Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta. Circ Cardiovasc Imaging. 2012;5:457–66.
73.
go back to reference Pedersen EM, Oyre S, Agerbaek M, Kristensen IB, Ringgaard S, Boesiger P, et al. Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo. Eur J Vasc Endovasc Surg. 1999;18:328–33.PubMedCrossRef Pedersen EM, Oyre S, Agerbaek M, Kristensen IB, Ringgaard S, Boesiger P, et al. Distribution of early atherosclerotic lesions in the human abdominal aorta correlates with wall shear stresses measured in vivo. Eur J Vasc Endovasc Surg. 1999;18:328–33.PubMedCrossRef
74.
go back to reference Wentzel JJ, Corti R, Fayad ZA, Wisdom P, Macaluso F, Winkelman MO, et al. Does shear stress modulate both plaque progression and regression in the thoracic aorta? Human study using serial magnetic resonance imaging. J Am Coll Cardiol. 2005;45:846–54.PubMedCrossRef Wentzel JJ, Corti R, Fayad ZA, Wisdom P, Macaluso F, Winkelman MO, et al. Does shear stress modulate both plaque progression and regression in the thoracic aorta? Human study using serial magnetic resonance imaging. J Am Coll Cardiol. 2005;45:846–54.PubMedCrossRef
75.
go back to reference Wang DH, Makaroun MS, Webster MW, Vorp DA. Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg. 2002;36:598–604.PubMedCrossRef Wang DH, Makaroun MS, Webster MW, Vorp DA. Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg. 2002;36:598–604.PubMedCrossRef
76.
go back to reference Meng H, Wang Z, Hoi Y, Gao L, Metaxa E, Swartz DD, et al. Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke. 2007;38:1924–31.PubMedCrossRef Meng H, Wang Z, Hoi Y, Gao L, Metaxa E, Swartz DD, et al. Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke. 2007;38:1924–31.PubMedCrossRef
77.
go back to reference Slager CJ, Wentzel JJ, Gijsen FJ, Schuurbiers JC, van der Wal AC, van der Steen AF, et al. The role of shear stress in the generation of rupture-prone vulnerable plaques. Nat Clin Pract Cardiovasc Med. 2005;2:401–7.PubMedCrossRef Slager CJ, Wentzel JJ, Gijsen FJ, Schuurbiers JC, van der Wal AC, van der Steen AF, et al. The role of shear stress in the generation of rupture-prone vulnerable plaques. Nat Clin Pract Cardiovasc Med. 2005;2:401–7.PubMedCrossRef
78.
go back to reference Dolan JM, Meng H, Singh S, Paluch R, Kolega J. High fluid shear stress and spatial shear stress gradients affect endothelial proliferation, survival, and alignment. Ann Biomed Eng. 2011;39:1620–31.PubMedCrossRef Dolan JM, Meng H, Singh S, Paluch R, Kolega J. High fluid shear stress and spatial shear stress gradients affect endothelial proliferation, survival, and alignment. Ann Biomed Eng. 2011;39:1620–31.PubMedCrossRef
79.
go back to reference Frydrychowicz A, Stalder AF, Russe MF, Bock J, Bauer S, Harloff A, et al. Three-dimensional analysis of segmental wall shear stress in the aorta by flow-sensitive 4-dimensional-MRI. J Magn Reson Imaging. 2009;30:77–84.PubMedCrossRef Frydrychowicz A, Stalder AF, Russe MF, Bock J, Bauer S, Harloff A, et al. Three-dimensional analysis of segmental wall shear stress in the aorta by flow-sensitive 4-dimensional-MRI. J Magn Reson Imaging. 2009;30:77–84.PubMedCrossRef
80.
go back to reference Crook SE, Hope MD. Arch hypoplasia and aneurysm after aortic coarctation repair: abnormal flow may be the link. JACC Cardiovasc Imaging. 2011;4:685–6.PubMedCrossRef Crook SE, Hope MD. Arch hypoplasia and aneurysm after aortic coarctation repair: abnormal flow may be the link. JACC Cardiovasc Imaging. 2011;4:685–6.PubMedCrossRef
81.
go back to reference Hope MD, Hope TA, Urbania TH, Higgins CB. Four-dimensional flow magnetic resonance imaging with wall shear stress analysis before and after repair of aortopulmonary fistula. Circ Cardiovasc Imaging. 2010;3:766–8.PubMedCrossRef Hope MD, Hope TA, Urbania TH, Higgins CB. Four-dimensional flow magnetic resonance imaging with wall shear stress analysis before and after repair of aortopulmonary fistula. Circ Cardiovasc Imaging. 2010;3:766–8.PubMedCrossRef
82.
go back to reference Hope MD, Dyverfeldt P, Acevedo-Bolton G, Wrenn J, Foster E, Tseng E, et al. Post-stenotic dilation: evaluation of ascending aortic dilation with 4D flow MR imaging. Int J Cardiol. 2012;156:e40–2.PubMedCrossRef Hope MD, Dyverfeldt P, Acevedo-Bolton G, Wrenn J, Foster E, Tseng E, et al. Post-stenotic dilation: evaluation of ascending aortic dilation with 4D flow MR imaging. Int J Cardiol. 2012;156:e40–2.PubMedCrossRef
83.
go back to reference Hope MD, Hope TA, Meadows AK, Ordovas KG, Urbania TH, Alley MT, et al. Bicuspid aortic valve: 4-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology. 2010;255:53–61.PubMedCrossRef Hope MD, Hope TA, Meadows AK, Ordovas KG, Urbania TH, Alley MT, et al. Bicuspid aortic valve: 4-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology. 2010;255:53–61.PubMedCrossRef
84.
go back to reference Hope MD, Meadows AK, Hope TA, Ordovas KG, Reddy GP, Alley MT, et al. Images in cardiovascular medicine. Evaluation of bicuspid aortic valve and aortic coarctation with 4D flow magnetic resonance imaging. Circulation. 2008;117:2818–9.PubMedCrossRef Hope MD, Meadows AK, Hope TA, Ordovas KG, Reddy GP, Alley MT, et al. Images in cardiovascular medicine. Evaluation of bicuspid aortic valve and aortic coarctation with 4D flow magnetic resonance imaging. Circulation. 2008;117:2818–9.PubMedCrossRef
85.
go back to reference Bauer M, Gliech V, Siniawski H, Hetzer R. Configuration of the ascending aorta in patients with bicuspid and tricuspid aortic valve disease undergoing aortic valve replacement with or without reduction aortoplasty. J Heart Valve Dis. 2006;15:594–600.PubMed Bauer M, Gliech V, Siniawski H, Hetzer R. Configuration of the ascending aorta in patients with bicuspid and tricuspid aortic valve disease undergoing aortic valve replacement with or without reduction aortoplasty. J Heart Valve Dis. 2006;15:594–600.PubMed
86.
go back to reference Cotrufo M, Della Corte A. The association of bicuspid aortic valve disease with asymmetric dilatation of the tubular ascending aorta: identification of a definite syndrome. J Cardiovasc Med. 2009;10:291–7.CrossRef Cotrufo M, Della Corte A. The association of bicuspid aortic valve disease with asymmetric dilatation of the tubular ascending aorta: identification of a definite syndrome. J Cardiovasc Med. 2009;10:291–7.CrossRef
87.
go back to reference Lu MT, Thadani SR, Hope MD. Quantitative assessment of asymmetric aortic dilation with valve-related aortic disease. Acad Radiol. 2012. [Epub ahead of print]. Lu MT, Thadani SR, Hope MD. Quantitative assessment of asymmetric aortic dilation with valve-related aortic disease. Acad Radiol. 2012. [Epub ahead of print].
88.
go back to reference Della Corte A, Quarto C, Bancone C, Castaldo C, Di Meglio F, Nurzynska D, et al. Spatiotemporal patterns of smooth muscle cell changes in ascending aortic dilatation with bicuspid and tricuspid aortic valve stenosis: focus on cell-matrix signaling. J Thorac Cardiovasc Surg. 2008;135:8–18. 18 e11–12.PubMedCrossRef Della Corte A, Quarto C, Bancone C, Castaldo C, Di Meglio F, Nurzynska D, et al. Spatiotemporal patterns of smooth muscle cell changes in ascending aortic dilatation with bicuspid and tricuspid aortic valve stenosis: focus on cell-matrix signaling. J Thorac Cardiovasc Surg. 2008;135:8–18. 18 e11–12.PubMedCrossRef
89.
go back to reference den Reijer PM, Sallee 3rd D, van der Velden P, Zaaijer ER, Parks WJ, et al. Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:4.CrossRef den Reijer PM, Sallee 3rd D, van der Velden P, Zaaijer ER, Parks WJ, et al. Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:4.CrossRef
90.
go back to reference • Della Corte A, Bancone C, Conti CA, Votta E, Redaelli A, Del Viscovo L, et al. Restricted cusp motion in right-left type of bicuspid aortic valves: A new risk marker for aortopathy. J Thorac Cardiovasc Surg. 2012;144:360–9, 369.e1. Restricted cusp motion with bicuspid aortic valves correlates with ascending aortic growth rates, suggesting underlying flow patterns have direct impact on disease progression. • Della Corte A, Bancone C, Conti CA, Votta E, Redaelli A, Del Viscovo L, et al. Restricted cusp motion in right-left type of bicuspid aortic valves: A new risk marker for aortopathy. J Thorac Cardiovasc Surg. 2012;144:360–9, 369.e1. Restricted cusp motion with bicuspid aortic valves correlates with ascending aortic growth rates, suggesting underlying flow patterns have direct impact on disease progression.
91.
go back to reference •• Hope MD, Wrenn SJ, Sigovan M, Foster E, Tseng E, Saloner D. Imaging biomarkers of aortic disease: increased growth rates with eccentric systolic flow. J Am Coll Cardiol. 2012;60:356–7. Eccentric systolic blood flow in the context of bicuspid aortic valve is correlated with increased aortic growth rates, suggesting a prognostic role for 4D Flow in the assessment of valve-related aortic disease.PubMedCrossRef •• Hope MD, Wrenn SJ, Sigovan M, Foster E, Tseng E, Saloner D. Imaging biomarkers of aortic disease: increased growth rates with eccentric systolic flow. J Am Coll Cardiol. 2012;60:356–7. Eccentric systolic blood flow in the context of bicuspid aortic valve is correlated with increased aortic growth rates, suggesting a prognostic role for 4D Flow in the assessment of valve-related aortic disease.PubMedCrossRef
Metadata
Title
Clinical Applications of Aortic 4D Flow Imaging
Authors
Michael D. Hope
S. Jarrett Wrenn
Petter Dyverfeldt
Publication date
01-04-2013
Publisher
Current Science Inc.
Published in
Current Cardiovascular Imaging Reports / Issue 2/2013
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-012-9187-8

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