Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI: Comparison With Transcranial Doppler Ultrasound

Simin Mahinrad; Can Ozan Tan; Yue Ma; Maria Aristova; Andrew L. Milstead; Donald Lloyd-Jones; Susanne Schnell; Michael Markl; Farzaneh A. Sorond

doi:10.1002/jmri.28115

Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI: Comparison With Transcranial Doppler Ultrasound

Simin Mahinrad^*, Can Ozan Tan, Yue Ma, Maria Aristova, Andrew L. Milstead, Donald Lloyd-Jones, Susanne Schnell, Michael Markl, Farzaneh A. Sorond

^*Corresponding author for this work

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

3 Scopus citations

Abstract

Background: Dual-venc 4D flow MRI, recently introduced for the assessment of intracranial hemodynamics, may provide a promising complementary approach to well-established tools such as transcranial Doppler ultrasound (TCD) and overcome some of their disadvantages. However, data comparing intracranial flow measures from dual-venc 4D flow MRI and TCD are lacking. Purpose: To compare cerebral blood flow velocity measures derived from dual-venc 4D flow MRI and TCD. Study Type: Prospective cohort. Subjects: A total of 25 healthy participants (56 ± 4 years old, 44% female). Field Strength/Sequence: A 3 T/dual-venc 4D flow MRI using a time-resolved three-dimensional phase-contrast sequence with three-dimensional velocity encoding. Assessment: Peak velocity measurements in bilateral middle cerebral arteries (MCA) were quantified from dual-venc 4D flow MRI and TCD. The MRI data were quantified by two independent observers (S.M and Y.M.) and TCD was performed by a trained technician (A.L.M.). We assessed the agreement between 4D flow MRI and TCD measures, and the interobserver agreement of 4D flow MRI measurements. Statistical Tests: Peak velocity from MRI and TCD was compared using Bland–Altman analysis and coefficient of variance. Intraclass correlation coefficient (ICC) was used to assess MRI interobserver agreement. A P value < 0.05 was considered statistically significant. Results: There was excellent interobserver agreement in dual-venc 4D flow MRI-based measurements of peak velocity in bilateral MCA (ICC = 0.97 and 0.96 for the left and right MCA, respectively). Dual-venc 4D flow MRI significantly underestimated peak velocity in the left and right MCA compared to TCD (bias = 0.13 [0.59, −0.33] m/sec and 0.15 [0.47, −0.17] m/sec, respectively). The coefficient of variance between dual-venc 4D flow MRI and TCD measurements was 26% for the left MCA and 22% for the right MCA. Data Conclusion: There was excellent interobserver agreement for the assessment of MCA peak velocity using dual-venc 4D flow MRI, and ≤20% under-estimation compared with TCD. Evidence Level: 3. Technical Efficacy: Stage 2.

Original language	English (US)
Pages (from-to)	1256-1264
Number of pages	9
Journal	Journal of Magnetic Resonance Imaging
Volume	56
Issue number	4
DOIs	https://doi.org/10.1002/jmri.28115
State	Published - Oct 2022

Keywords

4D flow MRI
cerebrovascular hemodynamics
healthy subjects
transcranial Doppler ultrasound

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1002/jmri.28115

Cite this

@article{f2d62ae777074fb68c806e528e60a1d6,

title = "Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI: Comparison With Transcranial Doppler Ultrasound",

abstract = "Background: Dual-venc 4D flow MRI, recently introduced for the assessment of intracranial hemodynamics, may provide a promising complementary approach to well-established tools such as transcranial Doppler ultrasound (TCD) and overcome some of their disadvantages. However, data comparing intracranial flow measures from dual-venc 4D flow MRI and TCD are lacking. Purpose: To compare cerebral blood flow velocity measures derived from dual-venc 4D flow MRI and TCD. Study Type: Prospective cohort. Subjects: A total of 25 healthy participants (56 ± 4 years old, 44% female). Field Strength/Sequence: A 3 T/dual-venc 4D flow MRI using a time-resolved three-dimensional phase-contrast sequence with three-dimensional velocity encoding. Assessment: Peak velocity measurements in bilateral middle cerebral arteries (MCA) were quantified from dual-venc 4D flow MRI and TCD. The MRI data were quantified by two independent observers (S.M and Y.M.) and TCD was performed by a trained technician (A.L.M.). We assessed the agreement between 4D flow MRI and TCD measures, and the interobserver agreement of 4D flow MRI measurements. Statistical Tests: Peak velocity from MRI and TCD was compared using Bland–Altman analysis and coefficient of variance. Intraclass correlation coefficient (ICC) was used to assess MRI interobserver agreement. A P value < 0.05 was considered statistically significant. Results: There was excellent interobserver agreement in dual-venc 4D flow MRI-based measurements of peak velocity in bilateral MCA (ICC = 0.97 and 0.96 for the left and right MCA, respectively). Dual-venc 4D flow MRI significantly underestimated peak velocity in the left and right MCA compared to TCD (bias = 0.13 [0.59, −0.33] m/sec and 0.15 [0.47, −0.17] m/sec, respectively). The coefficient of variance between dual-venc 4D flow MRI and TCD measurements was 26% for the left MCA and 22% for the right MCA. Data Conclusion: There was excellent interobserver agreement for the assessment of MCA peak velocity using dual-venc 4D flow MRI, and ≤20% under-estimation compared with TCD. Evidence Level: 3. Technical Efficacy: Stage 2.",

keywords = "4D flow MRI, cerebrovascular hemodynamics, healthy subjects, transcranial Doppler ultrasound",

author = "Simin Mahinrad and Tan, {Can Ozan} and Yue Ma and Maria Aristova and Milstead, {Andrew L.} and Donald Lloyd-Jones and Susanne Schnell and Michael Markl and Sorond, {Farzaneh A.}",

note = "Funding Information: The authors would like to thank Chaney R. Garner from Department of Neurology, Northwestern University, for technical assistance and data collection. This study is supported by the National Institute of Health (NIH, R01NS085002) and the National Heart, Lung, And Blood Institute of the National Institutes of Health, award number R01HL149787. M.A. was supported by a Ruth L. Kirchstein National Research Service Award (NIH F30 HL140910) and the Northwestern Medical Science Training Program (NIH T32 GM815229). The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Publisher Copyright: {\textcopyright} 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.",

year = "2022",

month = oct,

doi = "10.1002/jmri.28115",

language = "English (US)",

volume = "56",

pages = "1256--1264",

journal = "Journal of Magnetic Resonance Imaging",

issn = "1053-1807",

publisher = "John Wiley and Sons Inc.",

number = "4",

}

TY - JOUR

T1 - Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI

T2 - Comparison With Transcranial Doppler Ultrasound

AU - Mahinrad, Simin

AU - Tan, Can Ozan

AU - Ma, Yue

AU - Aristova, Maria

AU - Milstead, Andrew L.

AU - Lloyd-Jones, Donald

AU - Schnell, Susanne

AU - Markl, Michael

AU - Sorond, Farzaneh A.

N1 - Funding Information: The authors would like to thank Chaney R. Garner from Department of Neurology, Northwestern University, for technical assistance and data collection. This study is supported by the National Institute of Health (NIH, R01NS085002) and the National Heart, Lung, And Blood Institute of the National Institutes of Health, award number R01HL149787. M.A. was supported by a Ruth L. Kirchstein National Research Service Award (NIH F30 HL140910) and the Northwestern Medical Science Training Program (NIH T32 GM815229). The Coronary Artery Risk Development in Young Adults Study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). Publisher Copyright: © 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.

PY - 2022/10

Y1 - 2022/10

N2 - Background: Dual-venc 4D flow MRI, recently introduced for the assessment of intracranial hemodynamics, may provide a promising complementary approach to well-established tools such as transcranial Doppler ultrasound (TCD) and overcome some of their disadvantages. However, data comparing intracranial flow measures from dual-venc 4D flow MRI and TCD are lacking. Purpose: To compare cerebral blood flow velocity measures derived from dual-venc 4D flow MRI and TCD. Study Type: Prospective cohort. Subjects: A total of 25 healthy participants (56 ± 4 years old, 44% female). Field Strength/Sequence: A 3 T/dual-venc 4D flow MRI using a time-resolved three-dimensional phase-contrast sequence with three-dimensional velocity encoding. Assessment: Peak velocity measurements in bilateral middle cerebral arteries (MCA) were quantified from dual-venc 4D flow MRI and TCD. The MRI data were quantified by two independent observers (S.M and Y.M.) and TCD was performed by a trained technician (A.L.M.). We assessed the agreement between 4D flow MRI and TCD measures, and the interobserver agreement of 4D flow MRI measurements. Statistical Tests: Peak velocity from MRI and TCD was compared using Bland–Altman analysis and coefficient of variance. Intraclass correlation coefficient (ICC) was used to assess MRI interobserver agreement. A P value < 0.05 was considered statistically significant. Results: There was excellent interobserver agreement in dual-venc 4D flow MRI-based measurements of peak velocity in bilateral MCA (ICC = 0.97 and 0.96 for the left and right MCA, respectively). Dual-venc 4D flow MRI significantly underestimated peak velocity in the left and right MCA compared to TCD (bias = 0.13 [0.59, −0.33] m/sec and 0.15 [0.47, −0.17] m/sec, respectively). The coefficient of variance between dual-venc 4D flow MRI and TCD measurements was 26% for the left MCA and 22% for the right MCA. Data Conclusion: There was excellent interobserver agreement for the assessment of MCA peak velocity using dual-venc 4D flow MRI, and ≤20% under-estimation compared with TCD. Evidence Level: 3. Technical Efficacy: Stage 2.

AB - Background: Dual-venc 4D flow MRI, recently introduced for the assessment of intracranial hemodynamics, may provide a promising complementary approach to well-established tools such as transcranial Doppler ultrasound (TCD) and overcome some of their disadvantages. However, data comparing intracranial flow measures from dual-venc 4D flow MRI and TCD are lacking. Purpose: To compare cerebral blood flow velocity measures derived from dual-venc 4D flow MRI and TCD. Study Type: Prospective cohort. Subjects: A total of 25 healthy participants (56 ± 4 years old, 44% female). Field Strength/Sequence: A 3 T/dual-venc 4D flow MRI using a time-resolved three-dimensional phase-contrast sequence with three-dimensional velocity encoding. Assessment: Peak velocity measurements in bilateral middle cerebral arteries (MCA) were quantified from dual-venc 4D flow MRI and TCD. The MRI data were quantified by two independent observers (S.M and Y.M.) and TCD was performed by a trained technician (A.L.M.). We assessed the agreement between 4D flow MRI and TCD measures, and the interobserver agreement of 4D flow MRI measurements. Statistical Tests: Peak velocity from MRI and TCD was compared using Bland–Altman analysis and coefficient of variance. Intraclass correlation coefficient (ICC) was used to assess MRI interobserver agreement. A P value < 0.05 was considered statistically significant. Results: There was excellent interobserver agreement in dual-venc 4D flow MRI-based measurements of peak velocity in bilateral MCA (ICC = 0.97 and 0.96 for the left and right MCA, respectively). Dual-venc 4D flow MRI significantly underestimated peak velocity in the left and right MCA compared to TCD (bias = 0.13 [0.59, −0.33] m/sec and 0.15 [0.47, −0.17] m/sec, respectively). The coefficient of variance between dual-venc 4D flow MRI and TCD measurements was 26% for the left MCA and 22% for the right MCA. Data Conclusion: There was excellent interobserver agreement for the assessment of MCA peak velocity using dual-venc 4D flow MRI, and ≤20% under-estimation compared with TCD. Evidence Level: 3. Technical Efficacy: Stage 2.

KW - 4D flow MRI

KW - cerebrovascular hemodynamics

KW - healthy subjects

KW - transcranial Doppler ultrasound

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Intracranial Blood Flow Quantification by Accelerated Dual-venc 4D Flow MRI: Comparison With Transcranial Doppler Ultrasound

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