Abstract
Objective: We aim to validate four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) peak velocity tracking methods for measuring the peak velocity of mitral inflow against Doppler echocardiography.
Method: Fifty patients were recruited who had 4D flow CMR and Doppler Echocardiography. After transvalvular flow segmentation using established valve tracking methods, peak velocity was automatically derived using three-dimensional streamlines of transvalvular flow. In addition, a static planar method was used at the tip of mitral valve to mimic Doppler technique.
Results: Peak E-wave mitral inflow velocity was comparable between TTE and the novel 4D flow automated dynamic method (1.02±0.41 m/s vs 1.02±0.36 m/s; P=0.77) however there was a statistically significant difference when compared with the static planar method (0.93±0.37 m/s; P=0.04). Mean A-wave peak velocity was also comparable across TTE and the automated dynamic streamline (0.87±0.39 m/s vs 0.87±0.36 m/s; P=0.99). A significant difference was seen with the static planar method (0.78±0.36 m/s; P=0.04). E/A ratio was comparable between TTE and both the automated dynamic and static planar method (1.22±0.52 vs 1.20±0.34; p=0.76 and 1.36±0.81; p=0.25 respectively). Both novel 4D flow methods showed good correlation with TTE for E-wave (dynamic method; r=0.70; P<0.001 and static planar method; r=0.67; P<0.001) and A-wave velocity measurements (dynamic method; r=0.83; P<0.001 and static method; r=0.71; P<0.001). The automated dynamic method demonstrated excellent intra/inter-observer reproducibility for all parameters.
Conclusion: Automated dynamic peak velocity tracing method using 4D flow CMR is comparable to Doppler echocardiography for mitral inflow assessment and has excellent reproducibility for clinical use.
Method: Fifty patients were recruited who had 4D flow CMR and Doppler Echocardiography. After transvalvular flow segmentation using established valve tracking methods, peak velocity was automatically derived using three-dimensional streamlines of transvalvular flow. In addition, a static planar method was used at the tip of mitral valve to mimic Doppler technique.
Results: Peak E-wave mitral inflow velocity was comparable between TTE and the novel 4D flow automated dynamic method (1.02±0.41 m/s vs 1.02±0.36 m/s; P=0.77) however there was a statistically significant difference when compared with the static planar method (0.93±0.37 m/s; P=0.04). Mean A-wave peak velocity was also comparable across TTE and the automated dynamic streamline (0.87±0.39 m/s vs 0.87±0.36 m/s; P=0.99). A significant difference was seen with the static planar method (0.78±0.36 m/s; P=0.04). E/A ratio was comparable between TTE and both the automated dynamic and static planar method (1.22±0.52 vs 1.20±0.34; p=0.76 and 1.36±0.81; p=0.25 respectively). Both novel 4D flow methods showed good correlation with TTE for E-wave (dynamic method; r=0.70; P<0.001 and static planar method; r=0.67; P<0.001) and A-wave velocity measurements (dynamic method; r=0.83; P<0.001 and static method; r=0.71; P<0.001). The automated dynamic method demonstrated excellent intra/inter-observer reproducibility for all parameters.
Conclusion: Automated dynamic peak velocity tracing method using 4D flow CMR is comparable to Doppler echocardiography for mitral inflow assessment and has excellent reproducibility for clinical use.
| Original language | English |
|---|---|
| Pages (from-to) | 148-156 |
| Number of pages | 9 |
| Journal | International Journal of Cardiology |
| Volume | 364 |
| Early online date | 15 Jun 2022 |
| DOIs | |
| Publication status | Published - 1 Oct 2022 |
Keywords
- 4D flow CMR
- Mitral valve
- Peak velocity quantification
- Validation