Four-Dimensional Flow MRI for the Evaluation of Aortic Endovascular Graft: A Pilot Study

• Published in: Diagnostics (Basel) Vol. 13; no. 12; p. 2113
• Main Authors: Righini, Paolo, Secchi, Francesco, Mazzaccaro, Daniela, Giese, Daniel, Galligani, Marina, Avishay, Dor, Capra, Davide, Monti, Caterina Beatrice, Nano, Giovanni
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-06-2023; MDPI
• Subjects: aortic coarctation; Aortic dissection; Contrast agents; Coronary vessels; Flow velocity; Fluid dynamics; four-dimensional (4D) flow magnetic resonance; helical flow; Hemodynamics; Magnetic resonance imaging; Medical care; Medical imaging; Patients; Prostheses; Quality management; Shear stress; thoracic aortic dissection; thoracic aortic endovascular repair (TEVAR); Tomography; vortical flow; Germany; endoleak; thoracic aortic dissection; four-dimensional (4D) flow magnetic resonance; computational fluid dynamic (CFD); vortical flow; thoracic aortic endovascular repair (TEVAR); helical flow; aortic coarctation
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics13122113

We aimed to explore the feasibility of 4D flow magnetic resonance imaging (MRI) for patients undergoing thoracic aorta endovascular repair (TEVAR). We retrospectively evaluated ten patients (two female), with a mean (±standard deviation) age of 61 ± 20 years, undergoing MRI for a follow-up after TEVAR. All 4D flow examinations were performed using a 1.5-T system (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany). In addition to the standard examination protocol, a 4D flow-sensitive 3D spatial-encoding, time-resolved, phase-contrast prototype sequence was acquired. Among our cases, flow evaluation was feasible in all patients, although we observed some artifacts in 3 out of 10 patients. Three individuals displayed a reduced signal within the vessel lumen where the endograft was placed, while others presented with turbulent or increased flow. An aortic endograft did not necessarily hinder the visualization of blood flow through 4D flow sequences, although the graft could generate flow artifacts in some cases. A 4D Flow MRI may represent the ideal tool to follow up on both healthy subjects deemed to be at an increased risk based on their anatomical characteristics or patients submitted to TEVAR for whom a surveillance protocol with computed tomography angiography would be cumbersome and unjustified.