Reproducibility of quantitative analysis of aortic 4D flow data

Background 3D cine phase-contrast CMR ("4D Flow”) permits quantitative assessment of anomalous alterations of aortic blood flow. Two hemodynamic parameters that have been used for this purpose is the wall shear stress (WSS), which is known to regulate endothelial cell function, and the normalized flow displacement from the vessel center, which was recently shown to correlate with increased growth rates of ascending aortic dilation [1,2]. Analysis of these hemodynamic parameters requires that a user 1) positions a 2D plane of interest in the volumetric 4D Flow dataset and 2) delineates the contour of the vascular lumen in this 2D plane. We set out to assess the reproducibility of 4D Flow-based estimation of WSS and normalized flow displacement at these two critical levels of user-interaction. Furthermore, we assessed which of the parameters correlate best with aortic growth.