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Research ArticleAdult Brain
Open Access

High Spatiotemporal Resolution 4D Flow MRI of Intracranial Aneurysms at 7T in 10 Minutes

L.M. Gottwald, J. Töger, K. Markenroth Bloch, E.S. Peper, B.F. Coolen, G.J. Strijkers, P. van Ooij and A.J. Nederveen
American Journal of Neuroradiology July 2020, 41 (7) 1201-1208; DOI: https://doi.org/10.3174/ajnr.A6603
L.M. Gottwald
aFrom the Departments of Radiology and Nuclear Medicine (L.M.G., E.S.P., P.v.O., A.J.N.)
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J. Töger
cDepartment of Diagnostic Radiology (J.T.), Skane University Hospital, Lund, Sweden
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K. Markenroth Bloch
dLund University Bioimaging Center (K.M.B.), Lund University, Lund, Sweden.
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E.S. Peper
aFrom the Departments of Radiology and Nuclear Medicine (L.M.G., E.S.P., P.v.O., A.J.N.)
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B.F. Coolen
bBiomedical Engineering and Physics (B.F.C., G.J.S.), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
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G.J. Strijkers
bBiomedical Engineering and Physics (B.F.C., G.J.S.), Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
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P. van Ooij
aFrom the Departments of Radiology and Nuclear Medicine (L.M.G., E.S.P., P.v.O., A.J.N.)
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A.J. Nederveen
aFrom the Departments of Radiology and Nuclear Medicine (L.M.G., E.S.P., P.v.O., A.J.N.)
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  • FIG 1.
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    FIG 1.

    A, Flow rates of the outlet ROI of exemplary low (12 frames), moderate (16–24 frames), and high temporal resolution (30–40 frames). B, Zoomed view into the peak flow rate of the outlet ROI.

  • FIG 2.
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    FIG 2.

    Streamlines of patient 5 with an UIA to visualize blood flow patterns in the aneurysm (red arrow) of 10-mm diameter located at the left MCA. A video of streamlines of all five patients with UIAs over the cardiac cycle can be seen in the On-line Video. MCA indicates middle cerebral artery.

  • FIG 3.
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    FIG 3.

    Example WSS and OSI analysis of patient 5. Time-averaged WSS on the left, peak-systolic WSS in the middle, and OSI on the right for datasets with either 10 (upper row) or 30 (lower row) cardiac frames. MCA indicates middle cerebral artery; a.u., arbitrary units.

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    FIG 4.

    The changes in time-averaged WSS, peak systolic WSS, and OSI in the aneurysm and in the surrounding vessel when increasing the temporal resolution from 10 to 30 cardiac frames, or from 95 to 32 ms, respectively. ACOM indicates anterior communicating artery; ICA, internal carotid artery; MCA, middle cerebral artery; a.u., arbitrary units.

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    Table 1:

    Results of the flow phantom analysis in terms of peak flow rate difference, stroke volume difference, and the SD of the diastolic flow

    SequenceAcceleration FactorCardiac FramesMean Peak Flow Rate Difference (mL/s) (%)Mean Stroke Volume Difference (mL) (%)Mean Diastolic Flow Rate SE (mL/s)
    4D PROUD-13212−0.65 (−46.7%)−0.036 (−15.3%)0.028
    4D PROUD-22412−0.52 (−35.0%)−0.024 (−5.3%)0.018
    4D PROUD-31612−0.47 (−32.9%)−0.040 (−14.3%)0.033
    4D PROUD-5812−0.45 (−31.6%)−0.031 (−9.4%)0.035
    4D PROUD-41212−0.36 (−25.5%)−0.024 (−7.4%)0.021
    4D PROUD-6412−0.34 (−23.9%)−0.027 (−10.4%)0.027
    4D SENSE-1312−0.31 (−22.5%)−0.007 (−5.2%)0.047
    4D SENSE-2316−0.27 (−21.5%)−0.027 (−11.5%)0.031
    4D PROUD-51624−0.19 (−15.0%)−0.002 (−3.2%)0.029
    4D PROUD-33224−0.18 (−13.5%)−0.013 (−3.7%)0.029
    4D PROUD-6824−0.17 (−10.4%)−0.028 (−10.6%)0.024
    4D PROUD-62424−0.13 (−8.0%)−0.008 (−0.8%)0.028
    4D PROUD-52640−0.08 (−8.8%)−0.011 (−2.0%)0.027
    4D PROUD-43030−0.06 (−7.8%)0.005 (−3.3%)0.022
    4D PROUD-610300.05 (1.9%)−0.029 (−12.4%)0.027
    4D PROUD-61340−0.04 (−2.4%)−0.031 (−11.4%)0.024
    4D PROUD-52030−0.03 (−4.3%)0.003 (−4.9%)0.034
    2D reference-2240−0.05 (−3.7%)−0.006 (−3.0%)0.010
    2D reference-1a2400.00 (0.0%)0.000 (−0.0%)0.011
    • Note:—SE indicates standard error.

    • ↵a Used as a comparison baseline.

    • View popup
    Table 2:

    Results of the healthy subject analysis in terms of peak flow rate difference, peak flow rate repeatability, stroke volume difference, stroke volume repeatability, and pulsatility index difference

    Comparison PairsBland-AltmanOrthogonal Regression
    A (Frames)B (Frames)BiasLoAPEquationρ
    Peak flow rate difference (mL/s)2D reference-1 (30)4D PROUD-1 (30)0.31 ± 0.131.41.22y = 1.14x – 0.800.67
    2D reference-1 (30)4D PROUD-1 (15)0.51 ± 0.131.44.03y = 1.15x – 1.040.66
    2D reference-1 (30)4D PROUD-1 (7)0.76 ± 0.131.44<.01y = 0.90x – 0.420.60
    2D reference-1 (30)4D SENSE (7)0.79 ± 0.171.81.01y = 0.83x – 0.190.36
    Peak flow rate repeatability (mL/s)4D PROUD-1 (30)4D PROUD-2 (30)0.14 ± 0.080.90.61y = 0.87x + 0.280.87
    4D PROUD-1 (15)4D PROUD-2 (15)0.12 ± 0.080.87.90y = 0.84x + 0.370.88
    4D PROUD-1 (7)4D PROUD-2 (7)0.09 ± 0.070.71.77y = 0.90x + 0.170.89
    2D reference-1 (30)2D reference-2 (30)0.19 ± 0.080.86.38y = 1.01x – 0.230.86
    Stroke volume difference (mL)2D reference-1 (30)4D PROUD-1 (30)0.11 ± 0.090.94.53y = 0.99x – 0.080.64
    2D reference-1 (30)4D PROUD-1 (15)0.11 ± 0.090.94.45y = 0.97x – 0.040.64
    2D reference-1 (30)4D PROUD-1 (7)0.14 ± 0.090.93.36y = 0.95x – 0.030.64
    2D reference-1 (30)4D SENSE (7)0.15 ± 0.111.18.36y = 1.06x – 0.290.46
    Stroke volume repeatability (mL)4D PROUD-1 (30)4D PROUD-2 (30)0.08 ± 0.040.43.57y = 0.98x – 0.050.93
    4D PROUD-1 (15)4D PROUD-2 (15)0.08 ± 0.040.42.60y = 0.98x – 0.040.92
    4D PROUD-1 (7)4D PROUD-2 (7)0.07 ± 0.040.44.64y = 1.00x – 0.080.92
    2D reference-1 (30)2D reference-2 (30)0.06 ± 0.040.47.80y = 1.10x – 0.280.92
    Pulsatility index difference (a.u.)2D reference-1 (30)4D PROUD-1 (30)0.01 ± 0.040.39.41y = 1.97x – 0.820.15
    2D reference-1 (30)4D PROUD-1 (15)0.18 ± 0.040.39<.01y = 1.51x – 0.600.10
    2D reference-1 (30)4D PROUD-1 (7)0.31 ± 0.030.33<.01y = 0.01x + 0.510.01
    2D reference-1 (30)4D SENSE (7)0.31 ± 0.030.35<.01y = 0.03x + 0.500.02
    • Note:—LoA indicates limits of agreement; a.u., arbitrary units.

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L.M. Gottwald, J. Töger, K. Markenroth Bloch, E.S. Peper, B.F. Coolen, G.J. Strijkers, P. van Ooij, A.J. Nederveen
High Spatiotemporal Resolution 4D Flow MRI of Intracranial Aneurysms at 7T in 10 Minutes
American Journal of Neuroradiology Jul 2020, 41 (7) 1201-1208; DOI: 10.3174/ajnr.A6603

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High Spatiotemporal Resolution 4D Flow MRI of Intracranial Aneurysms at 7T in 10 Minutes
L.M. Gottwald, J. Töger, K. Markenroth Bloch, E.S. Peper, B.F. Coolen, G.J. Strijkers, P. van Ooij, A.J. Nederveen
American Journal of Neuroradiology Jul 2020, 41 (7) 1201-1208; DOI: 10.3174/ajnr.A6603
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