Quantification of aortic stiffness in stroke patients using 4D flow MRI in comparison with transesophageal echocardiography.

To quantify stiffness of the descending aorta (DAo) in stroke patients using 4D flow MRI and compare results with transesophageal echocardiography (TEE). 48 acute stroke patients undergoing 4D flow MRI and TEE were included. Intima-media-thickness (IMT) was measured in the DAo and the aorta was scrutinized for atherosclerotic plaques using TEE.

Quantification of Retrograde Blood Flow in the Descending Aorta Using Transesophageal Echocardiography in Comparison to 4D Flow MRI.

Background: Retrograde diastolic blood flow in the proximal descending aorta (DAo), which connects plaques ≥4 mm thickness with brain-supplying arteries, has previously been identified as a possible source of brain embolism. Currently, only 4D flow MRI is able to visualize and quantify potential retrograde embolization pathways in the DAo in-vivo. Hence, it was our aim to test if the extent of retrograde flow could be estimated by routine 2D transesophageal echocardiography (TEE).

Prevalence of potential retrograde embolization pathways in the proximal descending aorta in stroke patients and controls.

Background: Retrograde diastolic blood flow in the proximal descending aorta (DAo) connecting complex plaques (≥4 mm thick) with brain-supplying supra-aortic arteries may constitute a source of stroke. Yet, data only from high-risk populations (cryptogenic stroke patients with aortic atheroma≥3 mm) regarding the prevalence of this potential stroke mechanism are available. We aimed to quantify the frequency of this mechanism in unselected patients with cryptogenic stroke after routine diagnostics and controls without a history of stroke.

Accelerated analysis of three-dimensional blood flow of the thoracic aorta in stroke patients.

To test if new software accelerates analysis of in vivo acquired 4D flow MRI data. Respiration-gated and ECG-synchronized 4D flow MRI of the aorta was performed in 20 stroke patients using a routine 3-Tesla MRI system (TIMTRIO, Siemens, Germany). 3D blood flow data was processed by one experienced observer using new (A = MEVISFlow) and widely-used software (B = EnSight + Velomap-/FlowTool).