Feasibility of asymmetric stretch assessment in the ascending aortic wall with DENSE cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

David Saloner¹  Liang Ge⁴  Frederick H Epstein⁵  Xiaodong Zhong²  Elaine Tseng⁴  Gabriel Acevedo-Bolton³  Michael Hope³  Henrik Haraldsson⁶ 

[1]Veterans Affairs Medical Center, San Francisco, CA, USA

[2]MR R&D Collaborations, Siemens Healthcare, Atlanta, GA, USA

[3]Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA

[4]Department of Surgery, University of California, San Francisco, CA, USA

[5]Department of Biomedical Engineering, University of Virginia, Charlotteville, VA, USA

[6]VAMC/UCSF, Radiology 114-D, Bldg 203, Rm BA-51, 4150 Clement Street, San Francisco, CA 94530, USA

关键词: Cardiovascular magnetic resonance;    Bicuspid aortic valves;    Stiffness;    Stretch;    DENSE;    Aorta;   

Others  :  801941
DOI  :  10.1186/1532-429X-16-6

 received in 2013-09-09, accepted in 2013-12-27,  发布年份 2014

【 摘 要 】

Background

Vessel diameter is the principal imaging parameter assessed clinically for aortic disease, but adverse events can occur at normal diameters. Aortic stiffness has been studied as an additional imaging-based risk factor, and has been shown to be an independent predictor of cardiovascular morbidity and all-cause mortality. Reports suggest that some aortic pathology is asymmetric around the vessel circumference, a feature which would not be identified with current imaging approaches. We propose that this asymmetry may be revealed using Displacement Encoding with Stimulated Echoes (DENSE). The objective of this study is to investigate the feasibility of assessing asymmetric stretch in healthy and diseased ascending aortas using DENSE.

Methods

Aortic wall displacement was assessed with DENSE cardiovascular magnetic resonance (CMR) in 5 volunteers and 15 consecutive patients. Analysis was performed in a cross-sectional plane through the ascending aorta at the pulmonary artery. Displacement data was used to determine the wall stretch between the expanded and resting states of the aorta, in four quadrants around the aortic circumference.

Results

Analysis of variance (ANOVA) did not only show significant differences in stretch between groups of volunteers (p < 0.001), but also significant differences in stretch along the circumference of the aorta (p < 0.001), indicating an asymmetric stretch pattern. Furthermore, there is a significant difference in the asymmetry between volunteers and different groups of patients (p < 0.01).

Conclusions

Evaluation of asymmetric stretch is feasible in the ascending aorta with DENSE CMR. Clear differences in stretch are seen between patients and volunteers, with asymmetric patterns demonstrated around the aortic circumference.

【 授权许可】

   
2014 Haraldsson et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, Eagle KA, Hermann LK, Isselbacher EM, Kazerooni EA, Kouchoukos NT, Lytle BW, Milewicz DM, Reich DL, Sen S, Shinn JA, Svensson LG, Williams DM: ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010, 2010(121):e266-e369.
• [2]Poullis MP, Warwick R, Oo A, Poole RJ: Ascending aortic curvature as an independent risk factor for type A dissection, and ascending aortic aneurysm formation: a mathematical model. Eur J Cardiothorac Surg 2008, 33:995-1001.
• [3]Goergen CJ, Azuma J, Barr KN, Magdefessel L, Kallop DY, Gogineni A, Grewall A, Weimer RM, Connolly AJ, Dalman RL, Taylor CA, Tsao PS, Greve JM: Influences of aortic motion and curvature on vessel expansion in murine experimental aneurysms. Arterioscler Thromb Vasc Biol 2011, 31:270-279.
• [4]Doyle BJ, Callanan A, Burke PE, Grace PA, Walsh MT, Vorp DA, McGloughlin TM: Vessel asymmetry as an additional diagnostic tool in the assessment of abdominal aortic aneurysms. J Vasc Surg 2009, 49:443-454.
• [5]Fillinger MF, Marra SP, Raghavan ML, Kennedy FE: Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J Vasc Surg 2003, 37:724-732.
• [6]Shang EK, Nathan DP, Sprinkle SR, Vigmostad SC, Fairman RM, Bavaria JE, Gorman RC, Gorman JH 3rd, Chandran KB, Jackson BM: Peak wall stress predicts expansion rate in descending thoracic aortic aneurysms. Ann Thorac Surg 2013, 95:593-598.
• [7]Cavalcante JL, Lima JAC, Redheuil A, Al-Mallah MH: Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 2011, 57:1511-1522.
• [8]Adams JN, Brooks M, Redpath TW, Smith FW, Dean J, Gray J, Walton S, Trent RJ: Aortic distensibility and stiffness index measured by magnetic resonance imaging in patients with Marfan’s syndrome. Br Heart J 1995, 73:265-269.
• [9]Groenink M, de Roos A, Mulder BJ, Verbeeten B Jr, Timmermans J, Zwinderman AH, Spaan JA, van der Wall EE: Biophysical properties of the normal-sized aorta in patients with Marfan syndrome: evaluation with MR flow mapping. Radiology 2001, 219:535-540.
• [10]Cotrufo M, Della Corte A: The association of bicuspid aortic valve disease with asymmetric dilatation of the tubular ascending aorta: identification of a definite syndrome. J Cardiovasc Med (Hagerstown) 2009, 10:291-297.
• [11]Lu MT, Thadani SR, Hope MD: Quantitative assessment of asymmetric aortic dilation with valve-related aortic disease. Acad Radiol 2013, 20:10-15.
• [12]Redheuil A, Yu W-C, Mousseaux E, Harouni AA, Kachenoura N, Wu CO, Bluemke D, Lima JAC: Age-related changes in aortic arch geometry: relationship with proximal aortic function and left ventricular mass and remodeling. J Am Coll Cardiol 2011, 58:1262-1270.
• [13]Della Corte A, Quarto C, Bancone C, Castaldo C, Di Meglio F, Nurzynska D, De Santo LS, De Feo M, Scardone M, Montagnani S, Cotrufo M: Spatiotemporal patterns of smooth muscle cell changes in ascending aortic dilatation with bicuspid and tricuspid aortic valve stenosis: focus on cell-matrix signaling. J Thorac Cardiovasc Surg 2008, 135:8-18. 18.e1–2
• [14]Viscardi F, Vergara C, Antiga L, Merelli S, Veneziani A, Puppini G, Faggian G, Mazzucco A, Luciani GB: Comparative finite element model analysis of ascending aortic flow in bicuspid and tricuspid aortic valve. Artif Organs 2010, 34:1114-1120.
• [15]Hope MD, Hope TA, Meadows AK, Ordovas KG, Urbania TH, Alley MT, Higgins CB: Bicuspid aortic valve: four-dimensional MR evaluation of ascending aortic systolic flow patterns. Radiology 2010, 255:53-61.
• [16]Choudhury N, Bouchot O, Rouleau L, Tremblay D, Cartier R, Butany J, Mongrain R, Leask RL: Local mechanical and structural properties of healthy and diseased human ascending aorta tissue. Cardiovasc Pathol 2009, 18:83-91.
• [17]Iliopoulos DC, Deveja RP, Kritharis EP, Perrea D, Sionis GD, Toutouzas K, Stefanadis C, Sokolis DP: Regional and directional variations in the mechanical properties of ascending thoracic aortic aneurysms. Med Eng Phys 2009, 31:1-9.
• [18]Aletras AH, Ding S, Balaban RS, Wen H: DENSE: displacement encoding with stimulated echoes in cardiac functional MRI. J Magn Reson 1999, 137:247-252.
• [19]Li AE, Kamel I, Rando F, Anderson M, Kumbasar B, Lima JAC, Bluemke DA: Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. AJR Am J Roentgenol 2004, 182:593-597.
• [20]Azadani AN, Chitsaz S, Mannion A, Mookhoek A, Wisneski A, Guccione JM, Hope MD, Ge L, Tseng EE: Biomechanical properties of human ascending thoracic aortic aneurysms. Ann Thorac Surg 2013, 96:50-58.
• [21]Mendoza DD, Kochar M, Devereux RB, Basson CT, Min JK, Holmes K, Dietz HC, Milewicz DM, LeMaire SA, Pyeritz RE, Bavaria JE, Maslen CL, Song H, Kroner BL, Eagle KA, Weinsaft JW, GenTAC (National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) Study Investigators: Impact of image analysis methodology on diagnostic and surgical classification of patients with thoracic aortic aneurysms. Ann Thorac Surg 2011, 92:904-912.
• [22]Zhong X, Helm PA, Epstein FH: Balanced multipoint displacement encoding for DENSE MRI. Magn Reson Med 2009, 61:981-988.
• [23]Zhong X, Spottiswoode BS, Meyer CH, Kramer CM, Epstein FH: Imaging three-dimensional myocardial mechanics using navigator-gated volumetric spiral cine DENSE MRI. Magn Reson Med 2010, 64:1089-1097.
• [24]Griswold MA, Jakob PM, Heidemann RM, Nittka M, Jellus V, Wang J, Kiefer B, Haase A: Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 2002, 47:1202-1210.
• [25]Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P: SENSE: sensitivity encoding for fast MRI. Magn Reson Med 1999, 42:952-962.
• [26]Farnebäck G: Polynomial Expansion for Orientation and Motion Estimation. Sweden: Linköping University; 2002. [Ph.D. thesis] SE-581 83 Linköping, Sweden, 2002. Dissertation No 790, ISBN, 91-7373-475-6
• [27]Ebbers T, Farnebäck G: Improving computation of cardiovascular relative pressure fields from velocity MRI. J Magn Reson Imaging 2009, 30:54-61.
• [28]Moon-Ho Song S, Napel S, Pelc NJ, Glover GH: Phase unwrapping of MR phase images using Poisson equation. IEEE Trans Image Process 1995, 4:667-676.
• [29]Heiberg E, Sjögren J, Ugander M, Carlsson M, Engblom H, Arheden H: Design and validation of Segment–freely available software for cardiovascular image analysis. BMC Med Imaging 2010, 10:1. BioMed Central Full Text
• [30]Lin AP, Bennett E, Wisk LE, Gharib M, Fraser SE, Wen H: Circumferential strain in the wall of the common carotid artery: comparing displacement-encoded and cine MRI in volunteers. Magn Reson Med 2008, 60:8-13.
• [31]Sigfridsson A, Haraldsson H, Ebbers T, Knutsson H, Sakuma H: In vivo SNR in DENSE MRI; temporal and regional effects of field strength, receiver coil sensitivity and flip angle strategies. Magn Reson Imaging 2011, 29:202-208.
• [32]Wen H, Bennett E, Epstein N, Plehn J: Magnetic resonance imaging assessment of myocardial elastic modulus and viscosity using displacement imaging and phase-contrast velocity mapping. Magn Reson Med 2005, 54:538-548.
• [33]Laas J, Kleine P, Hasenkam MJ, Nygaard H: Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics. Ann Thorac Surg 1999, 68:1096-1099.