Decreased rotational flow and circumferential wall shear stress as early markers of descending aorta dilation in Marfan syndrome: a 4D flow CMR study.

BACKGROUND: Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. METHODS: Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. RESULTS: In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. CONCLUSIONS: Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.

Comparison of radial 4D Flow-MRI with perivascular ultrasound to quantify blood flow in the abdomen and introduction of a porcine model of pre-hepatic portal hypertension.

OBJECTIVES: Objectives of this study were to compare radial time-resolved phase contrast magnetic resonance imaging (4D Flow-MRI) with perivascular ultrasound (pvUS) and to explore a porcine model of acute pre-hepatic portal hypertension (PHTN). METHODS: Abdominal 4D Flow-MRI and pvUS in portal and splenic vein, hepatic and both renal arteries were performed in 13 pigs of approximately 60 kg. In six pigs, measurements were repeated after partial portal vein (PV) ligature. Inter- and intra-reader comparisons and statistical analysis including Bland-Altman (BA) comparison, paired Student's t tests and linear regression were performed. RESULTS: PvUS and 4D Flow-MRI measurements agreed well; flow before partial PV ligature was 322 ± 30 ml/min in pvUS and 297 ± 27 ml/min in MRI (p = 0.294), and average BA difference was 25 ml/min [-322; 372]. Inter- and intra-reader results differed very little, revealed excellent correlation (R 2 = 0.98 and 0.99, respectively) and resulted in BA differences of -5 ml/min [-161; 150] and -2 ml/min [-28; 25], respectively. After PV ligature, PV flow decreased from 356 ± 50 to 298 ± 61 ml/min (p = 0.02), and hepatic arterial flow increased from 277 ± 36 to 331 ± 65 ml/min (p = n.s.). CONCLUSION: The successful in vivo comparison of radial 4D Flow-MRI to perivascular ultrasound revealed good agreement of abdominal blood flow although with considerable spread of results. A model of pre-hepatic PHTN was successfully introduced and acute responses monitored. KEY POINTS: • Radial 4D Flow-MRI in the abdomen was successfully compared to perivascular ultrasound. • Inter- and intra-reader testing demonstrated excellent reproducibility of upper abdominal 4D Flow-MRI. • A porcine model of acute pre-hepatic portal hypertension was successfully introduced. • 4D Flow-MRI successfully monitored acute changes in a model of portal hypertension.

Non-contrast-enhanced MRA of renal artery stenosis: validation against DSA in a porcine model.

OBJECTIVES: To compare 3D-inversion-recovery balanced steady-state free precession (IR-bSSFP) non-contrast-enhanced magnetic resonance angiography (MRA) with 3D-contrast-enhanced MRA (CE-MRA) for assessment of renal artery stenosis (RAS) using digital subtraction angiography (DSA) as the reference standard. METHODS: Bilateral RAS were surgically created in 12 swine. IR-bSSFP and CE-MRA were acquired at 1.5 T and compared to rotational DSA. Three experienced cardiovascular radiologists evaluated the IR-bSSFP and CE-MRA studies independently. Linear regression models were used to calibrate and assess the accuracy of IR-bSSFP and CE-MRA, separately, against DSA. The coefficient of determination and Cohen's kappa coefficient were also generated. RESULTS: Calibration of the three readers' RAS grading revealed R(2) values of 0.52, 0.37 and 0.59 for NCE-MRA and 0.48, 0.53 and 0.71 for CE-MRA. Inter-rater agreement demonstrated Cohen's kappa values ranging from 0.25 to 0.65. Distal renal artery branch vessels were visible to a significantly higher degree with NCE-MRA compared to CE-MRA (p < 0.001). Image quality was rated excellent for both sequences, although image noise was higher with CE-MRA (p < 0.05). In no cases did noise interfere with image interpretation. CONCLUSIONS: In a well-controlled animal model of surgically induced RAS, IR-bSSFP based NCE-MRA and CE-MRA accurately graded RAS with a tendency for stenosis overestimation, compared to DSA. KEY POINTS: • IR-bSSFP and CE-MRA are accurate methods for diagnosis of renal artery stenosis • IR-bSSFP and CE-MRA demonstrate excellent agreement with DSA • Both IR-bSSFP and CE-MRA have a tendency to overestimate renal artery stenosis.

Four-dimensional velocity mapping of the hepatic and splanchnic vasculature with radial sampling at 3 tesla: a feasibility study in portal hypertension.

PURPOSE: To demonstrate the feasibility of PC-VIPR (Phase Contrast Vastly undersampled Imaging with Projection Reconstruction) for the depiction and hemodynamic analysis of hepatic and splanchnic vessels in patients with portal hypertension. MATERIALS AND METHODS: Twenty-four cirrhotic patients (55.9 ± 10.4 years) were scanned using 5-point PC-VIPR for high spatial resolution imaging with large volume coverage at 3 Tesla (T) using a 32-channel body coil. Vessel segmentation and hemodynamic visualization included color-coded three-dimensional (3D) streamlines and particle traces. Segmentation quality was compared with contrast-enhanced multi-phase liver imaging. Flow pattern analysis was performed in consensus of three readers. The MELD score was calculated to estimate disease severity and was correlated to image quality. RESULTS: Good to excellent visualization quality was achieved in 23/24 cases. All arterial vessels and 144/168 vessels of the portal venous (PV) circulation were unambiguously identified. No correlation with the MELD score was found. Eight of 148 vessels of the PV circulation demonstrated reverse (hepatofugal) flow. Hepatofugal flow in small tributaries to PV flow were present in three cases despite hepatopetal flow in the PV. CONCLUSION: This feasibility study demonstrates the feasibility of PC-VIPR for simultaneous morphological and hemodynamic assessment of the hepatic and splanchnic vasculature in cirrhosis and portal hypertension. Future studies with quantitative analyses are warranted.

Pressure Mapping and Hemodynamic Assessment of Intracranial Dural Sinuses and Dural Arteriovenous Fistulas with 4D Flow MRI.

The feasibility of 4D flow MR imaging to visualize flow patterns and generate relative pressure maps in the dural venous sinus in healthy subjects (n = 60) and patients with dural arteriovenous fistulas (n = 7) was investigated. Dural venous drainage was classified based on torcular Herophili anatomy by using 4D flow MR imaging-derived angiograms and magnitude images. Subjects were scanned in a 3T clinical MR imaging system. 4D flow MR imaging enabled noninvasive characterization of dural sinus anatomy and mapping of relative pressure differences.

Diagnostic value of high-resolution MR imaging in giant cell arteritis.

BACKGROUND AND PURPOSE: Clinical indications of giant cell arteritis may be unspecific, and noninvasive diagnosis is often difficult. This study investigated the hypothesis that high-resolution MR imaging of the superficial cranial arteries is a noninvasive imaging technique that can detect the occurrence of giant cell arteritis. MATERIALS AND METHODS: Contrast-enhanced, high-resolution MR imaging was performed on 64 consecutive patients with suspected giant cell arteritis. Mural thickness, lumen diameter, and a mural contrast enhancement score were assessed with T1-weighted spin-echo images with submillimeter in-plane spatial resolution. The final rheumatologist's diagnosis according to the clinical criteria of the American College of Rheumatology including laboratory tests and results of temporal artery biopsies from 32 patients was used as a "gold standard" for the evaluation of the MR imaging findings. RESULTS: All of the examinations provided diagnostic image quality. Evaluation of the mural inflammatory MR imaging signs for diagnosing vasculitis resulted in a sensitivity of 80.6% and a specificity of 97.0%. In comparison, histology results alone showed a sensitivity of 77.8% and specificity of 100%. The mean wall thickness increased significantly from 0.39 mm (+/-0.18 mm) to 0.74 mm (+/-0.32 mm; P < .001), and the lumen diameter decreased significantly from 0.84 mm (+/-0.29 mm) to 0.65 mm (+/-0.38 mm; P < .05) for patients with giant cell arteritis. CONCLUSION: Contrast-enhanced, high-resolution MR imaging allows noninvasive assessment of mural inflammation in giant cell arteritis with good diagnostic certainty. Measures of mural thickening and contrast enhancement can be obtained in these small vessels and provide valuable vasculitic MR imaging findings.

Noninvasive measurement of intra-aneurysmal pressure and flow pattern using phase contrast with vastly undersampled isotropic projection imaging.

BACKGROUND AND PURPOSE: Currently, more reliable parameters to predict the risk of aneurysmal rupture are needed. Intra-aneurysmal pressure gradients and flow maps could provide additional information regarding the risk of rupture. Our hypothesis was that phase contrast with vastly undersampled isotropic projection reconstruction (PC-VIPR), a novel 3D MR imaging sequence, could accurately assess intra-aneurysmal pressure gradients in a canine aneurysmal model when compared with invasive measurements. MATERIALS AND METHODS: A total of 13 surgically created aneurysms in 8 canines were included in this study. Pressure measurements were performed in the parent vessel, aneurysm neck, and 5 regions within the aneurysmal sac with a microcatheter. PC-VIPR sequence was used to obtain cardiac-gated velocity measurements in a region covering the entire aneurysm. The velocity and pressure gradient maps derived from the PC-VIPR data were then coregistered with the anatomic DSA images and compared with catheter measurements. RESULTS: In 7 of the bifurcation aneurysms, the velocity flow maps demonstrated a recirculation flow pattern with a small neck-to-dome pressure gradient (mean, +0.5 mm Hg). In 1 bifurcation aneurysm, a flow jet extending from the neck to the dome with significantly greater pressure gradient (+50.2 mm Hg) was observed. All sidewall aneurysms had low flow in the sac with intermediate pressure gradients (mean, +8.3 mm Hg). High statistical correlation existed between PC-VIPR aneurysmal pressures and microcatheter pressure measurements (R = 0.82, P < .01). CONCLUSION: PC-VIPR can provide anatomic as well as noninvasive quantitative and qualitative hemodynamic information in the canine aneurysm model. The PC-VIPR intra-aneurysmal pressure measurements correlated well with catheter measurements.

3D time-resolved contrast-enhanced cerebrovascular MR angiography with subsecond frame update times using radial k-space trajectories and highly constrained projection reconstruction.

HYPR TRICKS is an acquisition method that combines radial k-space trajectories, sampling k-space at different rates (TRICKS), and a new strategy for image reconstruction that uses highly constrained backprojection reconstruction (HYPR). This approach provides 3D time-resolved contrast-enhanced MR angiograms of the cerebral vessels with subsecond frame update times and submillimeter in-plane spatial resolution. Artifacts are suppressed, and signal-to-noise ratio is well maintained, by using HYPR reconstruction.

Fast contrast-enhanced 4D MRA and 4D flow MRI using constrained reconstruction (HYPRFlow): potential applications for brain arteriovenous malformations.

BACKGROUND AND PURPOSE: HYPRFlow is a novel imaging strategy that provides fast, high-resolution contrast-enhanced time-resolved images and measurement of the velocity of the entire cerebrovascular system. Our hypothesis was that the images obtained with this strategy are of adequate diagnostic image quality to delineate the major components of AVMs. MATERIALS AND METHODS: HYPRFlow and 3D TOF scans were obtained in 21 patients with AVMs with correlative DSA examinations in 14 patients. The examinations were scored for image quality and graded by using the Spetzler-Martin criteria. Mean arterial transit time and overlap integrals were calculated from the dynamic image data. Volume flow rates in normal arteries and AVM feeding arteries were measured from the phase contrast data. RESULTS: HYPRFlow was equivalent to 3D-TOF in delineating normal arterial anatomy, arterial feeders, and nidus size and was concordant with DSA for AVM grading and venous drainage in 13 of the 14 examinations. Mean arterial transit time on the AVM side was 0.49 seconds, and on the normal contralateral side, 2.53 seconds with P < .001. Across all 21 subjects, the mean arterial volume flow rate in the M1 segment ipsilateral to the AVM was 4.07 ± 3.04 mL/s; on the contralateral M1 segment, it was 2.09 ± 0.64 mL/s. The mean volume flow rate in the largest feeding artery to the AVM was 3.86 ± 2.74 mL/s. CONCLUSIONS: HYPRFlow provides an alternative approach to the MRA evaluation of AVMs, with the advantages of increased coverage, 0.75-second temporal resolution, 0.68-mm isotropic spatial resolution, and quantitative measurement of flow in 6 minutes.

Classification of premature ventricular complexes using filter bank features, induction of decision trees and a fuzzy rule-based system.

The classification of heart beats is important for automated arrhythmia monitoring devices. The study describes two different classifiers for the identification of premature ventricular complexes (PVCs) in surface ECGs. A decision-tree algorithm based on inductive learning from a training set and a fuzzy rule-based classifier are explained in detail. Traditional features for the classification task are extracted by analysing the heart rate and morphology of the heart beats from a single lead. In addition, a novel set of features based on the use of a filter bank is presented. Filter banks allow for time-frequency-dependent signal processing with low computational effort. The performance of the classifiers is evaluated on the MIT-BIH database following the AAMI recommendations. The decision-tree algorithm has a gross sensitivity of 85.3% and a positive predictivity of 85.2%, whereas the gross sensitivity of the fuzzy rule-based system is 81.3%, and the positive predictivity is 80.6%.

Reproducibility of cerebrospinal venous blood flow and vessel anatomy with the use of phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA.

BACKGROUND AND PURPOSE: The chronic cerebrospinal venous insufficiency hypothesis raises interest in cerebrospinal venous blood flow imaging, which is more complex and less established than in arteries. For accurate assessment of venous flow in chronic cerebrospinal venous insufficiency diagnosis and research, we must account for physiologic changes in flow patterns. This study examines day-to-day flow variability in cerebrospinal veins by use of 4D MR flow and contrast-enhanced MRA under typical, uncontrolled conditions in healthy individuals. MATERIALS AND METHODS: Ten healthy volunteers were scanned in a test-retest fashion by use of a 4D flow MR imaging technique and contrast-enhanced MRA. Flow parameters obtained from phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA scoring measurements in the head, neck, and chest veins were analyzed for internal consistency and interscan reproducibility. RESULTS: Internal consistency was satisfied at the torcular herophili, with an input-output difference of 2.2%. Percentages of variations in flow were 20.3%, internal jugular vein; 20.4%, azygos vein; 6.8%, transverse sinus; and 5.1%, common carotid artery. Retrograde flow was found in the lower internal jugular vein (4.8%) and azygos vein (7.2%). Contrast-enhanced MRA interscan κ values for the internal jugular vein (left: 0.474, right: 0.366) and azygos vein (-0.053) showed poor interscan agreement. CONCLUSIONS: Phase contrast-vastly undersampled isotropic projection reconstruction blood flow measurements are reliable and highly reproducible in intracranial veins and in the common carotid artery but not in veins of the neck (internal jugular vein) and chest (azygos vein) because of normal physiologic variation. Retrograde flow normally may be observed in the lower internal jugular vein and azygos vein. Low interrater agreement in contrast-enhanced MRA scans was observed. These findings have important implications for imaging diagnosis and experimental research of chronic cerebrospinal venous insufficiency.

Advanced technologies applied to physiopathological analysis of central nervous system aneurysms and vascular malformations.

While depiction and definition of morphological and architectural characteristics of CNS vascular disorders remains the first step of an MR analysis, emerging imaging techniques offer new functional information that might help to characterize rupture risk of CNS vascular disorders. Two main orientations are suggested by recent studies: inflammation of the vessel wall and analysis of physical constraints of blood flow using 4D flow imaging (shear parietal). This paper will focus on radiological application of 4D flow imaging and inflammation imaging, in the characterization of potential prognostic markers of CNS vascular disorders. We will review the basic technical considerations of 4D flow MRA, inflammation imaging and discuss their applications in CNS vascular disorders: aneurysms, arteriovenous malformation, dural arteriovenous fistulas. We will illustrate their potential in the development of individual rupture risk criteria in brain vascular disorders.

Measuring pulsatile flow in cerebral arteries using 4D phase-contrast MR imaging.

BACKGROUND AND PURPOSE: 4D PCMRI can be used to quantify pulsatile hemodynamics in multiple cerebral arteries. The aim of this study was to compare 4D PCMRI and 2D PCMRI for assessments of pulsatile hemodynamics in major cerebral arteries. MATERIALS AND METHODS: We scanned the internal carotid artery, the anterior cerebral artery, the basilar artery, and the middle cerebral artery in 10 subjects with a single 4D and multiple 2D PCMRI acquisitions by use of a 3T system and a 32-channel head coil. We assessed the agreement regarding net flow and the volume of arterial pulsatility (ΔV) for all vessels. RESULTS: 2D and 4D PCMRI produced highly correlated results, with r = 0.86 and r = 0.95 for ΔV and net flow, respectively (n = 69 vessels). These values increased to r = 0.93 and r = 0.97, respectively, during investigation of a subset of measurements with <5% variation in heart rate between the 4D and 2D acquisition (n = 31 vessels). Significant differences were found for ICA and MCA net flow (P = .004 and P < .001, respectively) and MCA ΔV (P = .006). However, these differences were attenuated and no longer significant when the subset with stable heart rate (n = 31 vessels) was analyzed. CONCLUSIONS: 4D PCMRI provides a powerful methodology to measure pulsatility of the larger cerebral arteries from a single acquisition. A large part of differences between measurements was attributed to physiologic variations. The results were consistent with 2D PCMRI.

MO-D-213CD-02: Non-Contrast-Enhanced Magnetic Resonance Angiography Methods for Assessment of Morphology and Flow.

Traditional clinical MR Angiography (MRA) provides volumetric datasets to characterize the vessel lumen. These MRA techniques can be generally separated into two categories: • contrast-enhanced MRA, which requires the venous injection of a paramagnetic contrast agent in form of a Gadolinium chelate and • non-contrast-enhanced MRA (NCE MRA), which relies on signal properties of the blood or the motion of the blood to create signal differences between the blood pool and the surrounding tissues. Time-of-Flight (TOF) and Phase- Contrast (PC) imaging have been developed as NCE techniques in the early days of MR imaging. However, widespread clinical adaptation of MRA did not occur until the introduction of CE-MRA in the mid-1990ies with significantly improved robustness. Recent developments have renewed the interest in imaging approaches that do not rely on any external contrast agents. Advances in hardware, especially gradient amplifiers and multi-channel coil technology, have reduced imaging times, improved the signal-to-noise ratio, and reduced artefacts so that NCE MRA is becoming competitive again. These approaches provide viable alternatives in patients that are at risk for nephrogenic systemic fibrosis (NSF) and should not receive a Gd-based contrast agent. In addition, some of those approaches provide insights in functional information beyond the standard luminography. For example, arterial spin labeling (ASL) imaging can be used as a 'pseudo arterial injection' by labeling blood in targeted volumes and tracking its distribution over time. Novel '4D MR Flow' imaging is an extension of traditional PC MRA to capture volumetric velocity vector fields throughout the cardiac cycle, thereby allowing for direct measures of hemdodynamic parameters such as pressure gradient, wall shear stress, pulse wave velocity, kinetic energy, and more. This lecture will provide an overview of the underlying contrast mechanisms of time-of-flight, phase-contrast, balanced steady state free precession (bSSFP), and ASL MRA. Current and potential future roles of these approaches in clinical imaging will also be discussed. LEARNING OBJECTIVES: 1. Understand the various origins of MRA contrast mechanisms that do not require a contrast agent. 2. Understand the issues related to NCE-MRA imaging including design, acquisition and processing. 3. Understand the benefits, pitfalls, and future potentials of these approaches. My research is sponsored by GE Healthcare.

Hemodynamic changes in patients with arteriovenous malformations assessed using high-resolution 3D radial phase-contrast MR angiography.

BACKGROUND AND PURPOSE: Arteriovenous malformations have a high lifetime risk of hemorrhage; however, treatment carries a significant risk of morbidity and mortality, including permanent neurologic sequelae. WSS and other hemodynamic parameters are altered in patients with symptomatic AVMs, and analysis of hemodynamics may have value in stratifying patients into different risk groups. In this study, we examined hemodynamic data from patients with stable symptoms and those who presented with acute symptoms to identify trends which may help in risk stratification. MATERIALS AND METHODS: Phase-contrast MRA using a radial readout (PC-VIPR) is a fast, high-resolution technique that can acquire whole-brain velocity-encoded angiograms with scan times of approximately 5 minutes. Ten patients with AVMs were scanned using PC-VIPR; velocity, area, flow, and WSS in vessels feeding the AVMs and normal contralateral vessels were calculated using velocity data from the phase-contrast acquisition. RESULTS: Patients with an asymptomatic presentation or mild symptoms (n = 4) had no significant difference in WSS in feeding vessels compared with normal contralateral vessels, whereas patients presenting with hemorrhage, severe headaches/seizures, or focal neurologic deficits (n = 6) had significantly higher WSS in feeding vessels compared with contralateral vessels. CONCLUSIONS: In this study, we demonstrate that estimates of WSS and other hemodynamic parameters can be obtained noninvasively in patients with AVMs in clinically useful imaging times. Variation in WSS between feeders and normal vessels appears to relate to the clinical presentation of the patient. Further analysis of hemodynamic changes may improve characterization and staging of AVM patients, when combined with existing risk factors.

Velocity measurements in the middle cerebral arteries of healthy volunteers using 3D radial phase-contrast HYPRFlow: comparison with transcranial Doppler sonography and 2D phase-contrast MR imaging.

BACKGROUND AND PURPOSE: We have developed PC HYPRFlow, a comprehensive MRA technique that includes a whole-brain CE dynamic series followed by PC velocity-encoding, yielding a time series of high-resolution morphologic angiograms with associated velocity information. In this study, we present velocity data acquired by using the PC component of PC HYPRFlow (PC-VIPR). MATERIALS AND METHODS: Ten healthy volunteers (6 women, 4 men) were scanned by using PC HYPRFlow and 2D-PC imaging, immediately followed by velocity measurements by using TCD. Velocity measurements were made in the M1 segments of the MCAs from the PC-VIPR, 2D-PC, and TCD examinations. RESULTS: PC-VIPR showed approximately 30% lower mean velocity compared with TCD, consistent with other comparisons of TCD with PC-MRA. The correlation with TCD was r = 0.793, and the correlation of PC-VIPR with 2D-PC was r = 0.723. CONCLUSIONS: PC-VIPR is a technique capable of acquiring high-resolution MRA of diagnostic quality with velocity data comparable with TCD and 2D-PC. The combination of velocity information and fast high-resolution whole-brain morphologic angiograms makes PC HYPRFlow an attractive alternative to current MRA methods.

The effect of spatial resolution on wall shear stress measurements acquired using radial phase contrast magnetic resonance angiography in the middle cerebral arteries of healthy volunteers. Preliminary results.

We have recently implemented radial phase-contrast techniques that allow high resolution angiograms with velocity information to be acquired within clinically-useful imaging times. 10 healthy volunteers were scanned using PC-VIPR and PC-SOS, two high resolution phase-contrast techniques at spatial resolutions of 0.67×0.67×0.67 mm(3) and 0.4×0.4×1 mm(3) respectively. The velocity measurements from the two acquisitions were imported into a custom Matlab runtime environment that automatically calculated WSS values using Green's Theorem and B-spline interpolation. Time average axial WSS was 1.069 N/m(2) (95% confidence interval: 0.8628< x < 1.276) in the left and right middle cerebral arteries of the 10 healthy volunteers (n=20) when scanned by PC-VIPR, and 1.670 N/m(2) when scanned by PC-SOS (95% confidence interval: 1.395 < x < 1.946). This difference in means was statistically significant (p < 0.002). Previous investigators have found that higher spatial resolution results in higher WSS measurements because smaller voxel size results in fewer partial volume effects. This was true in our study as well. In this study, we found that PC-SOS has significantly higher spatial resolution than PC-VIPR and this followed in the WSS measurements. Higher in-plane spatial resolution allows WSS calculations to be performed more accurately because of increased precision near the vessel boundary.

Accuracy and reproducibility of phase-contrast MR imaging measurements for CSF flow.

BACKGROUND AND PURPOSE: PCMR, widely used for the evaluation of blood flow, has been adopted for the assessment of cerebrospinal fluid flow in a variety of disorders. The purpose of this study was to evaluate the accuracy and reproducibility of 2 fast PCMR techniques for measuring CSF flow. MATERIALS AND METHODS: Velocities were calculated from RPC and CPC images of fluid flowing in a tube at a constant velocity. Error and the COV were computed for average and peak velocities. Additionally, measurements of sinusoidally fluctuating flow and of CSF flow in 5 healthy volunteers were acquired with the RPC and CPC acquisitions. RESULTS: For constant velocity experiments, error for the RPC and CPC acquisitions averaged +1.15% and +8.91% and COVs averaged 1.29% and 3.01%, respectively. For peak velocities of >or=12.6 cm/s, error with RPC or CPC ranged from -33.3% to -36.9% and COVs were 0%-4% for RPC and 1%-7% for CPC. For peak velocities of 250%. For fluctuating flow, both acquisitions showed similar flow patterns. In volunteer studies, peak systolic and diastolic velocities were not significantly different. CONCLUSIONS: The RPC and CPC sequences measure velocities on the order of CSF flow with an average error of >or=9%. The 2 techniques significantly overestimate peak velocities <6.4 cm/s, with maximum errors of 209% and 276% and maximum COVs of 100% and 73% for the RPC and CPC sequences, respectively. Measurements of CSF velocities in human volunteers and of sinusoidally fluctuating phantom velocities did not differ significantly between the 2 techniques.