Ozden Kilinc¹, Stanley Chu¹, Justin Baraboo^1,2, Elizabeth K. Weiss^1,2, Anthony Maroun¹, Ning Jin³, Kelvin Chow^1,4, Xiaoming Bi⁴, Rachel Davids⁴, Chris Mehta⁵, S. Chris Malaisrie⁵, Andrew Hoel⁶, Michael Markl^1,2, and Bradley D. Allen^1
1Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States, ²Department of Biomedical Engineering, Northwestern University, Chicago, IL, United States, ³Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Cleveland, OH, United States, ⁴Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Chicago, IL, United States, ⁵Division of Cardiac Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States, ⁶Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States

4D flow MRI is a well-validated imaging technique for quantitative assessment of blood flow hemodynamics and has shown promise in evaluation of type B aortic dissection (TBAD). However, single velocity encoding (venc) 4D flow MRI is limited by its inability to fully capture wide range of velocities related to variable pathologic hemodynamic patterns such as true lumen and false lumen flow range of velocities in TBAD. We hypothesize that dual-venc acquisition improves velocity-to-noise ratio, better captures full dynamic range of velocities in TBAD and provides improved characterization of flow hemodynamics relative to single-venc acquisitions.

HongZhou Zhang^1,2, Shuang Leng^1,3, Ru-San Tan^1,3, Ping Chai^4,5, Jennifer Bryant^1,3, Lynette Teo^5,6, Ching Ching Ong^4,5, Angela S. Koh^1,3, Wen Ruan¹, James W. Yip^4,5, Ju Le Tan^1,3, and Liang Zhong^1,3
1National Heart Centre Singapore, Singapore, Singapore, ²Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China, ³Duke-NUS Medical School, Singapore, Singapore, ⁴National University Heart Centre, Singapore, Singapore, ⁵Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, ⁶National University Hospital, Singapore, Singapore

This study aimed to introduce a novel parameter—aorta (AO) global longitudinal strain (GLS)—for AO stiffness assessment by semi-automated feature tracking approach with standard cine cardiovascular magnetic resonance (CMR). The data demonstrated excellent intra and inter-observer variability of AO GLS of 4.4% and 5.0%, respectively. AO GLS was significantly negatively associated with age. The mean AO GLS was greater in females (10.1±3.5% versus 8.1±2.7%, P<0.001). The AO GLS decreased by 1.68% in females and 1.32% in males per decade respectively. Age was an independent predictor of the AO GLS in both males and females.

Yu-Ru Yang¹, Meng-Chu Chang¹, Ming-Ting Wu², Ken-Pen Weng³, and Hsu-Hsia Peng^1
1Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan, ²Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ³Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

The aortic hemodynamic flow pattern and aortic kinetic energy (KE) is less discussed for repaired tetralogy of Fallot (rTOF) patients without aortic root dilatation. We aimed to evaluate aortic KE in rTOF patients with or without aortic root dilatation. The rTOF1 patients (indexed aortic root diameter<16 mm/m²) demonstrated aortic regurgitation. Both rTOF1 and rTOF2 (indexed aortic root diameter≥16 mm/m²) patients exhibited normal aortic vorticity and decreased aortic KE. In conclusion, in rTOF patients with preserved left ventricular ejection fraction, the altered velocity-derived KE and RF can provide an indication of aortapathy progress earlier than morphological aortic dilatation and aortic vorticity.

Xiaoqian Zhang¹, Sirui Liu¹, Feng Feng¹, and Zhentao Zuo^2,3
1Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, ²State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China, ³Department of Human Anatomy, Histology and Embryology, School of Basic Medicine, Peking Union Medical College, Beijing, China

The study investigated relationship between cerebral small vessel disease (CSVD) burden, cerebral blood flow (CBF) and cardiovascular risk in the aging brains with normal cognitive function at baseline and conducted telephone cognitive follow-up for nearly 8 years. The results showed that severe CSVD burden was significantly associated with higher cardiovascular risk scores and decreased CBF in multiple areas, with involvement of nearly all cortical brain areas. Subjects with severe CSVD burden were more likely to suffer from long-term cognitive decline. This suggests the capability of CSVD burden serving as an imaging marker of predicting cognitive decline.

Tomoko Hyodo¹, Daisuke Morimoto-Ishikawa^2,3, Hayato Kaida¹, Yu Ueda⁴, Daisuke Tomita⁵, Atsuhiro Yamamoto⁵, Makoto Itoh², Nao Yasuda², Hiroyuki Fukushima², Yuji Nozaki⁵, Itaru Matsumura⁵, and Kazunari Ishii^1
1Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan, ²Radiology Center, Kindai University Hospital, Osaka-Sayama, Japan, ³Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan, ⁴Philips Japan, Tokyo, Japan, ⁵Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan

The ascending aorta is poorly delineated on DWI due to the heartbeat, making it difficult to assess the activity of large vessel vasculitis using MRI. We investigated the utility of acceleration motion compensation diffusion-weighted imaging (aMC-DWI) compared with conventional DWI (cDWI) to detect active inflammation of the accenting aorta. The phantom experiment revealed that aMC-DWI showed a significantly higher median visual score than cDWI in both experimenters (P =.048 for both). The clinical study on 11 patients showed that aMC-DWI had higher sensitivity, specificity, and positive predictive value (with FDG-PET/CT as the reference method) than cDWI.

Isao Shiina¹, Michinobu Nagao², Masami Yoneyama³, Yasuhiro Goto¹, Yutaka Hamatani¹, Kazuo Kodaira¹, Takumi Ogawa¹, Mana Kato¹, and Shuji Sakai^2
1Department of Radiological Services, Tokyo Woman's Medical University, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Woman's Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

Cardiac bSSFP CINE imaging is widely used in clinical practice for function and morphological evaluation, but we often experienced situations where it is difficult to visually evaluate blood flow and valves. TFEPI is a flow-sensitive imaging method and can be expected to evaluate blood flow and valves. In this study, we investigate the clinical usefulness of Flow sensitive CINE Imaging using TFEPI.

Qichang Fu¹, Yi Zhang¹, Jingliang Cheng¹, Sheng Guan², and Chengcheng Zhu^3
1Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Department of Interventional Neuroradiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³Department of Radiology, University of Washington, Washington, WA, United States

This study used DCE-MRI and VWI to explore the value of K^trans and aneurysm wall enhancement (AWE) in screening UIAs instability. Eighty-two patients were enrolled, including 51 patients with stable IAs and 31 patients with unstable IAs. All patients completed examinations based on a 3.0T Siemens Prisma magnetic resonance. Multivariate logistic regression revealed that AWEP (OR, 4.1; 95% CI, 2.06 to 8.16; P < 0.001) and K^trans (OR, 2.77; 95% CI, 1.49 to 5.17; P = 0.01) were the only independent factors associated with unstable UIAs. Both K^trans and AWEP were independent risk factors for the unstable state of UIAs.

Mingzhu Fu¹, Fei Peng², Wenwen Chen¹, Aihua Aihua Liu², and Rui Li^1
1Department of Biomedical Engineering, Tsinghua University, Center for Biomedical Imaging Research, Beijing, China, ²Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China

In this study, we utilized HR-VWI and 3D TOF-MRA images to investigate the relationship between AWE grades and aneurysm inflow angle. Statistics indicated that the AWE grades were positively associated with the aneurysm inflow angle. This is probably because a sidewall aneurysm with high inflow angle is easier to grow and cause slower inflow velocity and lower wall shear stress which contribute to inflammation processes on aneurysmal wall and lead to a high grade of AWE. The results of this study showed that the AWE was positively associated with aneurysm inflow angle.

Wenbo Zhang¹, Jingliang zhang Cheng¹, Liangjie Lin², Yong zhang Zhang¹, Keyan zhang Wang¹, Huiyu zhang Huang¹, Qi Ren¹, and WenHua Zhang^1
1MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Philips Healthcare, Beijing, China

The feasibility of non-contrast-enhanced coronary MR angiography (CMRA) with acceleration by compressed sensing (CS) was assessed in patients with suspected coronary artery diseases on a 3.0 T scanner, compared with conventional coronary MRA. Results indicate that the whole-heart non-contrast CMRA accelerated by CS with a factor of 4 obtained relatively high sensitivity, positive predictive value, negative predictive value and accuracy in a significantly shortened acquisition time compared with conventional CMRA.

Kun Peng¹, Yong Liu¹, Ting Hua¹, Xianling Zhang², Xiance Zhao³, Jilei Zhang³, and Guangyu Tang^1
1Department of Radiology, Shanghai Tenth People’s Hospital, School of Medicine，Tongji University, Shanghai, China, ²Department of Cardiology, Shanghai Tenth People’s Hospital, School of Medicine，Tongji University, Shanghai, China, ³Philips Healthcare, Shanghai, China

Four-dimensional flow magnetic resonance imaging (4D-flow MRI) technique has been developed to assess intra-cavity left ventricular (LV) blood flow. Hypertensive heart disease (HHD) is a common cardiovascular disease and manifested as left ventricular hypertrophy and diastolic/systolic dysfunction. The purpose of this study was to investigate whether 4D-flow CMR kinetic energy (KE) parameters are sensitive to distinguish HHD patients from age/gender-matched healthy controls, and to access if there are significant differences in different sub-groups of LV ejection fraction. We also aimed to investigate the association of LV KE to LV function parameters and LV mass.

Huiying Wu¹, Ning Zhou¹, Zhe Wen², Lianwei Lu¹, Mingjie Zhang¹, Fuyu You², Tao Liu², Yunzhu Wu³, and Xiaochun Zhang*^1
1Radiology, Guangzhou Women and Children’s Medical Center, Guangzhou, China, ²Pediatric Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou, China, ³MR Scientific Marketing, Siemens Healthineers, Guangzhou, China

This preliminary study has investigated the feasibility of free-breathing 4D-flow MRI to evaluate portal hemodynamics in children with EHPVO. Free-breathing 4D-flow MRI is feasible and hopeful for the comprehensive 3D visualization and quantification of portal vein flow dynamics in 14 children and the peak velocity had similar diagnostic efficiency to ultrasound in our study. In the future, we intend to compare 4D-flow parameters with intraoperative manometry of the portal vein system and use the noninvasive radionics methodology to estimate portal vein hemodynamics in children.

Yu-Cheng Lin¹, Ming-Ting Wu², Ken-Pen Weng³, and Hsu-Hsia Peng^1
1Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan, ²Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ³Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

The interaction of aortic wall characteristics and cardiac function in Fontan patients is unclear.  4D flow MRI was employed to quantify the wall shear stress (WSS) and oscillatory shear index (OSI) in the aorta. Fontan patients exhibited increased axial WSS, decreased axial OSI and non-roundness of WSS in descending aorta (DAo). We also found that the increased axial WSS in DAo correlated with decreased ejection fraction and increased indexed end-systolic volume. The cardiac dysfunction presented adverse interaction with aortic wall characteristics in patients with Fontan, especially in DAo, and might lead to higher risk of atherosclerosis and stenosis.

XianKuo Hu¹, Yang Zhang², XiaoHu Li³, Yu Shan Yuan², Bin Peng¹, and YuanYuan Li^2
1Fuyang People's Hospital, fuyang, China, ²Fuyang People's Hospital, FuYang, China, ³the First Affiliated Hospital of Anhui Medical University, hefei, China

MR Coronary angiography (MRCA) technology can observe the anatomical morphology of coronary arteries and detect lumen stenosis, dilation, and abnormal wall lesions [1]. MRCA technology is relatively complex with long scanning time [2]. Compressed SENSE (CS) technology can greatly shorten the scanning time and improve the rate of succussed examination. This study aim to explore the clinical feasibility of Compressed SENSE technology in non-contrast agent MRA and explore the best acceleration factor of CS.

Aiqi Sun¹, Bo Zhao², Yichen Zheng³, Yuliang Long⁴, Peng Wu⁵, and He Wang^1,6
1Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, ²University of Texas at Austin, Austin, TX, United States, ³Beijing PINS Medical Co., Ltd, Beijing, China, ⁴Department of Cardiology, Zhongshan hospital Fudan University, Shanghai, China, ⁵Philips Healthcare, Shanghai, China, ⁶Human Phenome Institute, Fudan, Shanghai, China

Conventional 4D flow MRI requires electrocardiogram gated cine acquisition and respiration control to measure flow dynamics associated with one synthetic cardiac cycle. This often leads to low acquisition efficiency and also cannot resolve beat-by-beat nor respiratory-related flow variations. This work presents a new 4D real-time flow MRI method which is able to simultaneously resolve respiratory and cardiac motion. Compared to conventional 4D flow MRI, the proposed method well captures the beat-by-beat flow variations and respiration-related flow dynamics. Its feasibility for aortic flow was demonstrated in several healthy subjects and also patients with atrial fibrillation.

Wen Zeng¹, Chunchao Xia¹, Xiaoyong Zhang², and Zhenlin Li^1
1West China Hospital, Sichuan University, Chengdu, China, ²Clinical Science, Philips Healthcare, Chengdu, China, Chengdu, China

Four-dimensional flow MRI (4D flow MRI) plays a significant role in cardiovascular imaging, which provides new insights into the pathophysiology of disease. In this study, 4D flow with echo-planar imaging was introduced to evaluate the hemodynamic parameters of patients with abdominal aortic aneurysm, including velocity, flow and wall shear stress. We propose that 4D EPI flow can find differences of the above parameters between abdominal aortic aneurysm and normal abdominal aorta and has potential to be used for hemodynamics assessment in AAA patients.