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Volume 13
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Article

4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot

by
Ashifa Hudani
1,2,
Safia Ihsan Ali
1,2,
David Patton
3,4,
Kimberley A. Myers
3,
Nowell M. Fine
4,5,
James A. White
2,4,5,
Steven Greenway
4,5,6,7 and
Julio Garcia
2,4,5,6,8,*
1
Department of Biomedical Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
2
Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
3
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
4
Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
5
Libin Cardiovascular Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
6
Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
7
Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
8
Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
*
Author to whom correspondence should be addressed.
Appl. Sci. 2023, 13(5), 2810; https://doi.org/10.3390/app13052810
Submission received: 1 February 2023 / Revised: 18 February 2023 / Accepted: 20 February 2023 / Published: 22 February 2023
(This article belongs to the Special Issue Artificial Intelligence Techniques for Medical Imaging and Computational Biology)
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Repaired Tetralogy of Fallot pulmonary hemodynamic alterations can be characterized by 4D-flow MRI.

Abstract

Patients with Tetralogy of Fallot (TOF) have multiple surgical sequelae altering the pulmonary flow hemodynamics. Repaired TOF (rTOF) adults frequently develop pulmonary regurgitation impacting the blood flow pressure, right ventricle load, and pulmonary hemodynamics. We aimed to evaluate the pulmonary flow hemodynamics using 4D-flow magnetic resonance imaging (MRI) for characterizing altered blood flow, viscous energy loss (EL), wall shear stress (WSS), pressure drop (PD), and ventricular flow analysis (VFA) in rTOF patients. We hypothesized that 4D-flow based parameters can identify pulmonary blood flow alterations. A total of 17 rTOF patients (age: 29 ± 10 years, 35% women) and 20 controls (age: 36 ± 12 years, 25% women) were scanned using a dedicated cardiac MRI protocol. Peak velocity and regurgitant fraction were significantly higher for rTOF patients (p < 0.001). WSS was consistently elevated along the PA in the rTOF (p ≤ 0.05). The rTOF average circumferential WSS was higher than axial WSS at the main pulmonary artery (p ≤ 0.001). PD and EL were consistently higher in the rTOF as compared with controls (p < 0.05). For VFA, delayed ejection increased and retained inflow decreased in rTOF patients (p < 0.001). To conclude, this study demonstrated that 4D-flow MRI pulmonary flow in the rTOF can exhibit altered peak velocity, valvular regurgitation, WSS, EL, PD, and VFA.
Keywords: 4D-flow MRI; repaired tetralogy of Fallot; pulmonary flow 4D-flow MRI; repaired tetralogy of Fallot; pulmonary flow

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MDPI and ACS Style

Hudani, A.; Ihsan Ali, S.; Patton, D.; Myers, K.A.; Fine, N.M.; White, J.A.; Greenway, S.; Garcia, J. 4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot. Appl. Sci. 2023, 13, 2810. https://doi.org/10.3390/app13052810

AMA Style

Hudani A, Ihsan Ali S, Patton D, Myers KA, Fine NM, White JA, Greenway S, Garcia J. 4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot. Applied Sciences. 2023; 13(5):2810. https://doi.org/10.3390/app13052810

Chicago/Turabian Style

Hudani, Ashifa, Safia Ihsan Ali, David Patton, Kimberley A. Myers, Nowell M. Fine, James A. White, Steven Greenway, and Julio Garcia. 2023. "4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot" Applied Sciences 13, no. 5: 2810. https://doi.org/10.3390/app13052810

APA Style

Hudani, A., Ihsan Ali, S., Patton, D., Myers, K. A., Fine, N. M., White, J. A., Greenway, S., & Garcia, J. (2023). 4D-Flow MRI Characterization of Pulmonary Flow in Repaired Tetralogy of Fallot. Applied Sciences, 13(5), 2810. https://doi.org/10.3390/app13052810

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