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Quantification of blood flow in the fetus with cardiovascular magnetic resonance imaging using Doppler ultrasound gating: validation against metric optimized gating
- Source :
- Journal of Cardiovascular Magnetic Resonance, Journal of Cardiovascular Magnetic Resonance, Vol 21, Iss 1, Pp 1-15 (2019)
- Publication Year :
- 2019
-
Abstract
- Introduction Fetal cardiovascular magnetic resonance (CMR) imaging is used clinically and for research, but has been previously limited due to lack of direct gating methods. A CMR-compatible Doppler ultrasound (DUS) gating device has resolved this. However, the DUS-gating method is not validated against the current reference method for fetal phase-contrast blood flow measurements, metric optimized gating (MOG). Further, we investigated how different methods for vessel delineation affect flow volumes and observer variability in fetal flow acquisitions. Aims To 1) validate DUS gating versus MOG for quantifying fetal blood flow; 2) assess repeatability of DUS gating; 3) assess impact of region of interest (ROI) size on flow volume; and 4) compare time-resolved and static delineations for flow volume and observer variability. Methods Phase-contrast CMR was acquired in the fetal descending aorta (DAo) and umbilical vein by DUS gating and MOG in 22 women with singleton pregnancy in gestational week 360 (265–400) with repeated scans in six fetuses. Impact of ROI size on measured flow was assessed for ROI:s 50–150% of the vessel diameter. Four observers from two centers provided time-resolved and static delineations. Bland-Altman analysis was used to determine agreement between both observers and methods. Results DAo flow was 726 (348–1130) ml/min and umbilical vein flow 366 (150–782) ml/min by DUS gating. Bias±SD for DUS-gating versus MOG were − 45 ± 122 ml/min (−6 ± 15%) for DAo and 19 ± 136 ml/min (2 ± 24%) for umbilical vein flow. Repeated flow measurements in the same fetus showed similar volumes (median CoV = 11% (DAo) and 23% (umbilical vein)). Region of interest 50–150% of vessel diameter yielded flow 35–120%. Bias±SD for time-resolved versus static DUS-gated flow was 33 ± 39 ml/min (4 ± 6%) for DAo and 11 ± 84 ml/min (2 ± 15%) for umbilical vein flow. Conclusions Quantification of blood flow in the fetal DAo and umbilical vein using DUS-gated phase-contrast CMR is feasible and agrees with the current reference method. Repeatability was generally high for CMR fetal blood flow assessment. An ROI similar to the vessel area or slightly larger is recommended. A static ROI is sufficient for fetal flow quantification using currently available CMR sequences.
- Subjects :
- Adult
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Umbilical Veins
Aorta, Thoracic
Gestational Age
Gating
030204 cardiovascular system & hematology
Umbilical vein
Ultrasonography, Prenatal
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Region of interest
Predictive Value of Tests
Pregnancy
medicine
Humans
Radiology, Nuclear Medicine and imaging
Doppler ultrasound gating
Fetal blood flow
Angiology
Cardiovascular magnetic resonance imaging
Observer Variation
Ontario
Sweden
Fetus
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
Research
Reproducibility of Results
Magnetic resonance imaging
Ultrasonography, Doppler
Blood flow
Repeatability
Magnetic Resonance Imaging
lcsh:RC666-701
Regional Blood Flow
Female
Cardiology and Cardiovascular Medicine
Nuclear medicine
business
Metric optimized gating
Blood Flow Velocity
Subjects
Details
- ISSN :
- 1532429X
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
- Accession number :
- edsair.doi.dedup.....302d89887d7508671b199db86e7259d8