Background: The main complication in adult patients with transposition of the great arteries (TGA) treated by an arterial switch operation (ASO) is neopulmonary outflow tract stenosis (NPOTS). However, pulmonary flow velocity measurements cannot always be performed with transthoracic echocardiography (TTE) due to complex anatomical features. 4D flow MRI allows detection, quantification, and location of the obstruction site along the NPOTS.
Purpose And Hypothesis: To investigate the accuracy of 4D flow for the diagnosis of NPOTS in adults with TGA corrected by ASO.
Study Type: Prospective.
Population: Thirty-three adult patients with TGA treated by ASO (19 men, mean age 25.5 years old).
Field Strength/sequence: Accelerated 4D flow research sequence at 3T.
Assessment: Maximum NPOTS velocities on TTE and 4D flow MRI done the same day.
Statistical Tests: Pearson correlation coefficient, paired t-test, and Bland-Altman analysis were used to investigate the relationship between TTE and MRI data.
Results: In 16 patients (48.5%), evaluation of NPOTS anatomy was not obtained by TTE, while it was always possible by 4D flow. Peak flow velocity (PV) measurements in Doppler and 4D flow were highly correlated (r = 0.78; P < 0.001). PV >350 cm.s was detected in only one patient (3%) by TTE vs. five patients (15%) by 4D flow. Moreover, a high correlation was found between PV and the right ventricle (RV) mass index to body surface area when using 4D flow (r = 0.63; P < 0.001). The location of NPOTS was determined in all patients using 4D flow and concerned the main pulmonary artery in 42%.
Data Conclusion: Compared to TTE, 4D flow MRI provides better sensitivity to detect and locate NPOTS in patients with TGA treated by ASO. 4D flow PV measurements in NPOTS were well correlated with TTE PV and RV mass.
Level Of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1699-1705.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/jmri.27012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Parietal Meningocele Under the Scalp of a Fetus Diagnosed Based on Volume Contrast Imaging of Prenatal Three-Dimensional Ultrasound Data.
Case Rep Neurol Med
January 2025
Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.
Determining the differential diagnosis of small scalp cysts identified on a fetus is difficult. In particular, many physicians have difficulty differentiating small meningoceles from small scalp cysts during the prenatal period. Volume contrast imaging increases contrast between tissues, thereby allowing an enhanced view of target structures.
View Article and Find Full Text PDFCatheter ablation of atrial flutter in an adult with a univentricular heart, common atrium, and single atrioventricular valve: a case report-'complex things don't always require a complex solution'.
Eur Heart J Case Rep
January 2025
Cardiac Electrophysiology, National Medical Center 'November 20th', ISSSTE, Av. Felix Cuevas #540, Col. Del Valle Del. Benito Juarez, C.P. 03100 Mexico City, Mexico.
Background: The 'univentricular' heart encompasses a variety of congenital cardiac defects characterized by a single functional ventricle and an underdeveloped ventricular chamber. Surgical intervention, typically in infancy or childhood, aims to regulate pulmonary blood flow volume. In adulthood, untreated patients may experience limitations in physical activity and elevated morbidity due to persistent cyanosis and arrhythmias, notably after the Fontan procedure.
View Article and Find Full Text PDFImpact of different glycoprotein IIb/IIIa inhibitor infusion routes on infarct size and microvascular obstruction in patients with high thrombotic risk ST elevation myocardial infarction.
Acta Cardiol
January 2025
Division of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Objective: Current guidelines recommend the use of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibitors in patients with ST-segment elevation myocardial infarction (STEMI) only as a bail-out therapy. However, drug penetration to the jeopardised area may not be achieved due to impeded blood flow and increased microvascular resistance. Aim of our study is to investigate the impact of distal intracoronary GpIIb/IIIa inhibitor agent infusion in STEMI patients.
View Article and Find Full Text PDFResting state BOLD-perfusion coupling patterns using multiband multi-echo pseudo-continuous arterial spin label imaging.
Sci Rep
January 2025
Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
The alteration of neurovascular coupling (NVC), where acute localized blood flow increases following neural activity, plays a key role in several neurovascular processes including aging and neurodegeneration. While not equivalent to NVC, the coupling between simultaneously measured cerebral blood flow (CBF) with arterial spin labeling (ASL) and blood oxygenation dependent (BOLD) signals, can also be affected. Moreover, the acquisition of BOLD data allows the assessment of resting state (RS) fMRI metrics.
View Article and Find Full Text PDFAssociations between potential risk factors and blood-brain barrier water permeability in middle-aged and older adults.
J Alzheimers Dis
January 2025
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Blood-brain barrier (BBB) dysfunction is suggested to be a potential mediator between vascular risk factors and cognitive impairment, leading to vascular cognitive impairment. To investigate the relationships between age, sex, and vascular risk factors and BBB water permeability as well as their relationship with cognition. To measure BBB permeability, a novel arterial spin labelling MRI technique (ME-ASL) was applied to derive the time of exchange (Tex), arterial time transit (ATT), and cerebral blood flow (CBF).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!