4D flow magnetic resonance imaging in bicuspid aortic valve disease demonstrates altered distribution of aortic blood flow helicity

R. Lorenz*, J. Bock, A. J. Barker, F. Von Knobelsdorff-Brenkenhoff, W. Wallis, J. G. Korvink, M. M. Bissell, J. Schulz-Menger, M. Markl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Purpose Changes in aortic geometry or presence of aortic valve (AoV) disease can result in substantially altered aortic hemodynamics. Dilatation of the ascending aorta or AoV abnormalities can result in an increase in helical flow. Methods 4D flow magnetic resonance imaging was used to test the feasibility of quantitative helicity analysis using equidistantly distributed 2D planes along the entire aorta. The evaluation of the method included three parts: (1) the quantification of helicity in 12 healthy subjects, (2) an evaluation of observer variability and test-retest reliability, and (3) the quantification of helical flow in 16 patients with congenitally altered bicuspid AoVs. Results Helicity quantification in healthy subjects revealed consistent directions of flow rotation along the entire aorta with high clockwise helicity in the aortic arch and an opposite rotation sense in the ascending and descending aorta. The results demonstrated good scan-rescan and inter- and intraobserver agreement of the helicity parameters. Helicity quantification in patients revealed a significant increase in absolute peak relative helicity during systole and a considerably greater heterogeneous distribution of mean helicity in the aorta. Conclusion The method has the potential to serve as a reference distribution for comparisons of helical flow between healthy subjects and patients or between different patient groups.

Original languageEnglish (US)
Pages (from-to)1542-1553
Number of pages12
JournalMagnetic resonance in medicine
Volume71
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • aorta
  • aortic valve disease
  • bicuspid aortic valve
  • blood flow helicity
  • helicity quantification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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