4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters

J.F. Juffermans; H.C. van Assen; B.J.C. te Kiefte; M.J.F.G. Ramaekers; R.L.F. van der Palen; P. van den Boogaard; B.P. Adriaans; J.E. Wildberger; I.A. Dekkers; A.J.H.A. Scholte; S. Schalla; H.J. Lamb; J.J.M. Westenberg

doi:10.3390/app12083912

4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters

J.F. Juffermans^*, H.C. van Assen, B.J.C. te Kiefte, M.J.F.G. Ramaekers, R.L.F. van der Palen, P. van den Boogaard, B.P. Adriaans, J.E. Wildberger, I.A. Dekkers, A.J.H.A. Scholte, S. Schalla, H.J. Lamb, J.J.M. Westenberg

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

(1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flow jet angle, wall shear stress (WSS) magnitude, axial WSS, circumferential WSS, WSS angle, vorticity, helicity, and local normalized helicity (LNH)) in TAA patients; (2) Methods: The thoracic aorta of 20 patients was semi-automatically segmented on 4D flow MRI data in 5 systolic phases by 3 different observers. Each time-dependent segmentation was manually improved and partitioned into six anatomical segments. The hemodynamic parameters were quantified per phase and segment. The coefficient of variation (COV) and intraclass correlation coefficient (ICC) were calculated; (3) Results: A total of 2400 lumen segments were analyzed. The mean aneurysm diameter was 50.8 +/- 2.7 mm. The intra- and interobserver analysis demonstrated a good reproducibility (COV = 16-30% and ICC = 0.84-0.94) for normalized flow displacement and jet angle, a very good-to-excellent reproducibility (COV = 3-26% and ICC = 0.87-1.00) for all WSS components, helicity and LNH, and an excellent reproducibility (COV = 3-10% and ICC = 0.96-1.00) for vorticity; (4) Conclusion: 4D flow MRI-derived hemodynamic parameters are reproducible within the thoracic aorta in TAA patients.

Original language	English
Article number	3912
Number of pages	15
Journal	Applied Sciences
Volume	12
Issue number	8
DOIs	https://doi.org/10.3390/app12083912
Publication status	Published - 1 Apr 2022

Keywords

aorta
aneurysm
hemodynamic
4D flow MRI
reproducibility
WALL SHEAR-STRESS
VALVE
QUANTIFICATION
ACCURACY
DIAMETER
PATTERNS
VELOCITY
SIZE

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10.3390/app12083912Licence: CC BY

Cite this

Juffermans, J. F., van Assen, H. C., te Kiefte, B. J. C., Ramaekers, M. J. F. G., van der Palen, R. L. F., van den Boogaard, P., Adriaans, B. P., Wildberger, J. E., Dekkers, I. A., Scholte, A. J. H. A., Schalla, S., Lamb, H. J., & Westenberg, J. J. M. (2022). 4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters. Applied Sciences, 12(8), Article 3912. https://doi.org/10.3390/app12083912

@article{17a830bd64b44b5ca1859d3f8585d1f4,

title = "4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters",

abstract = "(1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flow jet angle, wall shear stress (WSS) magnitude, axial WSS, circumferential WSS, WSS angle, vorticity, helicity, and local normalized helicity (LNH)) in TAA patients; (2) Methods: The thoracic aorta of 20 patients was semi-automatically segmented on 4D flow MRI data in 5 systolic phases by 3 different observers. Each time-dependent segmentation was manually improved and partitioned into six anatomical segments. The hemodynamic parameters were quantified per phase and segment. The coefficient of variation (COV) and intraclass correlation coefficient (ICC) were calculated; (3) Results: A total of 2400 lumen segments were analyzed. The mean aneurysm diameter was 50.8 +/- 2.7 mm. The intra- and interobserver analysis demonstrated a good reproducibility (COV = 16-30% and ICC = 0.84-0.94) for normalized flow displacement and jet angle, a very good-to-excellent reproducibility (COV = 3-26% and ICC = 0.87-1.00) for all WSS components, helicity and LNH, and an excellent reproducibility (COV = 3-10% and ICC = 0.96-1.00) for vorticity; (4) Conclusion: 4D flow MRI-derived hemodynamic parameters are reproducible within the thoracic aorta in TAA patients.",

keywords = "aorta, aneurysm, hemodynamic, 4D flow MRI, reproducibility, WALL SHEAR-STRESS, VALVE, QUANTIFICATION, ACCURACY, DIAMETER, PATTERNS, VELOCITY, SIZE",

author = "J.F. Juffermans and {van Assen}, H.C. and {te Kiefte}, B.J.C. and M.J.F.G. Ramaekers and {van der Palen}, R.L.F. and {van den Boogaard}, P. and B.P. Adriaans and J.E. Wildberger and I.A. Dekkers and A.J.H.A. Scholte and S. Schalla and H.J. Lamb and J.J.M. Westenberg",

note = "Funding Information: Funding: This work was funded by the Dutch Heart Foundation (CVON2017-08-RADAR). Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = apr,

day = "1",

doi = "10.3390/app12083912",

language = "English",

volume = "12",

journal = "Applied Sciences",

issn = "2076-3417",

publisher = "Politechnica University of Bucharest",

number = "8",

}

Juffermans, JF, van Assen, HC, te Kiefte, BJC, Ramaekers, MJFG, van der Palen, RLF, van den Boogaard, P, Adriaans, BP , Wildberger, JE, Dekkers, IA, Scholte, AJHA, Schalla, S, Lamb, HJ & Westenberg, JJM 2022, '4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters', Applied Sciences, vol. 12, no. 8, 3912. https://doi.org/10.3390/app12083912

TY - JOUR

T1 - 4D Flow MRI in Ascending Aortic Aneurysms: Reproducibility of Hemodynamic Parameters

AU - Juffermans, J.F.

AU - van Assen, H.C.

AU - te Kiefte, B.J.C.

AU - Ramaekers, M.J.F.G.

AU - van der Palen, R.L.F.

AU - van den Boogaard, P.

AU - Adriaans, B.P.

AU - Wildberger, J.E.

AU - Dekkers, I.A.

AU - Scholte, A.J.H.A.

AU - Schalla, S.

AU - Lamb, H.J.

AU - Westenberg, J.J.M.

PY - 2022/4/1

Y1 - 2022/4/1

N2 - (1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flow jet angle, wall shear stress (WSS) magnitude, axial WSS, circumferential WSS, WSS angle, vorticity, helicity, and local normalized helicity (LNH)) in TAA patients; (2) Methods: The thoracic aorta of 20 patients was semi-automatically segmented on 4D flow MRI data in 5 systolic phases by 3 different observers. Each time-dependent segmentation was manually improved and partitioned into six anatomical segments. The hemodynamic parameters were quantified per phase and segment. The coefficient of variation (COV) and intraclass correlation coefficient (ICC) were calculated; (3) Results: A total of 2400 lumen segments were analyzed. The mean aneurysm diameter was 50.8 +/- 2.7 mm. The intra- and interobserver analysis demonstrated a good reproducibility (COV = 16-30% and ICC = 0.84-0.94) for normalized flow displacement and jet angle, a very good-to-excellent reproducibility (COV = 3-26% and ICC = 0.87-1.00) for all WSS components, helicity and LNH, and an excellent reproducibility (COV = 3-10% and ICC = 0.96-1.00) for vorticity; (4) Conclusion: 4D flow MRI-derived hemodynamic parameters are reproducible within the thoracic aorta in TAA patients.

AB - (1) Background: Aorta hemodynamics have been associated with aortic remodeling, but the reproducibility of its assessment has been evaluated marginally in patients with thoracic aortic aneurysm (TAA). The current study evaluated intra- and interobserver reproducibility of 4D flow MRI-derived hemodynamic parameters (normalized flow displacement, flow jet angle, wall shear stress (WSS) magnitude, axial WSS, circumferential WSS, WSS angle, vorticity, helicity, and local normalized helicity (LNH)) in TAA patients; (2) Methods: The thoracic aorta of 20 patients was semi-automatically segmented on 4D flow MRI data in 5 systolic phases by 3 different observers. Each time-dependent segmentation was manually improved and partitioned into six anatomical segments. The hemodynamic parameters were quantified per phase and segment. The coefficient of variation (COV) and intraclass correlation coefficient (ICC) were calculated; (3) Results: A total of 2400 lumen segments were analyzed. The mean aneurysm diameter was 50.8 +/- 2.7 mm. The intra- and interobserver analysis demonstrated a good reproducibility (COV = 16-30% and ICC = 0.84-0.94) for normalized flow displacement and jet angle, a very good-to-excellent reproducibility (COV = 3-26% and ICC = 0.87-1.00) for all WSS components, helicity and LNH, and an excellent reproducibility (COV = 3-10% and ICC = 0.96-1.00) for vorticity; (4) Conclusion: 4D flow MRI-derived hemodynamic parameters are reproducible within the thoracic aorta in TAA patients.

KW - aorta

KW - aneurysm

KW - hemodynamic

KW - 4D flow MRI

KW - reproducibility

KW - WALL SHEAR-STRESS

KW - VALVE

KW - QUANTIFICATION

KW - ACCURACY

KW - DIAMETER

KW - PATTERNS

KW - VELOCITY

KW - SIZE

U2 - 10.3390/app12083912

DO - 10.3390/app12083912

M3 - Article

SN - 2076-3417

VL - 12

JO - Applied Sciences

JF - Applied Sciences

IS - 8

M1 - 3912

ER -