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4D MRI Could Improve Clinical Assessment of Heart Blood Flow Abnormalities

By MedImaging International staff writers
Posted on 19 Mar 2024

Image: 4D flow MRI enables unobstructed in-vivo assessment of time-resolved 3D blood velocity (Photo courtesy of Northwestern University)

Magnetic Resonance Imaging (MRI) utilizes magnets and pulsed radio frequency to generate computer images for screening and diagnosing medical conditions. 4D flow MRI, an advanced imaging technique, provides a more detailed view of the heart and the aorta by adding movement as a fourth dimension. This allows healthcare professionals to see how blood moves through the cardiovascular system in detail and identify any potential issues that may require further examination. Previous studies have indicated that evaluating blood stasis and peak velocity in the left atrium and its appendage using 4D flow could aid in identifying impaired blood flow, which increases the risk of forming blood clots. However, the relationship between conventional volumetric and functional left atrium parameters with flow characteristics in the left atrium and left atrium appendage had not been fully investigated until now.

Now, a study by researchers from Northwestern University (Evanston, IL, USA) has discovered that combining whole-heart 4D flow with short-axis cine MRI can identify characteristics linked to poor blood flow in the heart’s left atrial chamber. These insights could enable doctors to more accurately diagnose abnormalities in heart blood flow. The study aimed to explore whether the relation between 4D flow parameters and conventional volumetric-based left atrial assessment could help better identify participants with impaired flow characteristics and improve the understanding of mechanistic relationships between left atrial flow and volumetric parameters. The study involved data from 158 patients all of whom underwent prospective cardiac MRI exams consisting of whole-heart 4D flow and short-axis cine imaging. The analysis of the 4D flow MRI involved manual 3D segmentation of the left atrium and its appendage to measure peak velocity and blood stasis.

The team utilized short-axis cine data to define left atrial contours, extracting 3D–based left atrial volume measures to calculate left atrial emptying fractions [total LA emptying fractions (LAEFtotal), active LA emptying fraction (LAEFactive), and passive LA emptying fraction (LAEFpassive)]. They also measured left atrial stasis, left atrial peak velocity, left atrium appendage stasis, and left atrium appendage peak velocity flow parameters to detect any connection with left atrial volume and left atrial emptying fraction. The researchers found that a one-unit increase in LAEFtotal was related to reduced left atrial stasis (p < 0.001) and higher LAEFactive was related to increased left atrial peak velocity (p < 0.001). They also found that increased minimum left atrial volume was most likely related to impaired left atrial appendage flow and lower left atrial appendage peak velocity.

"Increased absolute and indexed minimum left atrial volume was most closely associated with impaired left atrial flow, which is a known risk factor for left atrial thrombus formation and potentially ischemic stroke," the researchers concluded. "Thus, 3D-based left atrial volume quantification may be a useful surrogate measure for left atrial and left atrial appendage flow abnormalities in future studies."

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89 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

91 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

92 (651.12113952637): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294800596 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

93 (574.11193847656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

94 (689.98336791992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

95 (410.79521179199): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294800596 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

96 (510.93101501465): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

97 (328.06396484375): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

98 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

99 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

100 (131.13021850586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

101 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

102 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

103 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

104 (194.07272338867): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

105 (!!!!! 82355.02243042): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

106 (!!!!! 16515.970230103): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

107 (143.05114746094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

108 (!!!!! 3556.0131072998): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800596 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800596 AND type='deeppockets_item' AND published='1' LIMIT 1

109 (!!!!! 1142532.1102142): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

110 (277.99606323242): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

111 (281.09550476074): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

112 (350.9521484375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

113 (155.92575073242): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

114 (174.99923706055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

115 (224.11346435547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

116 (208.85467529297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

117 (!!!!! 1734.9720001221): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

118 (!!!!! 1083.1356048584): SELECT name FROM jos_deeppockets WHERE id=212

119 (39.100646972656): SELECT name FROM jos_deeppockets WHERE id=212

120 (702.85797119141): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

121 (590.80123901367): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

122 (789.88075256348): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

123 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

124 (!!!!! 17004.013061523): TRUNCATE TABLE jos_trademed_module

125 (335.9317779541): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294800596 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

126 (447.98851013184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

127 (315.90461730957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

128 (458.0020904541): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

129 (!!!!! 2377.0332336426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

130 (!!!!! 1066.9231414795): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

131 (368.11828613281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

132 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

133 (735.99815368652): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800596 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800596 AND type='deeppockets_item' AND published='1' LIMIT 1

134 (36.954879760742): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

135 (30.040740966797): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

136 (!!!!! 2892.017364502): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

137 (659.94262695312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

138 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800596 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800596 AND published='1' LIMIT 1

139 (509.97734069824): select jos_twitters.link from jos_twitters where cat=10

140 (259.8762512207): select jos_facebook.link from jos_facebook where cat=10

141 (329.97131347656): select jos_google_plus.link from jos_google_plus where cat=10

142 (272.03559875488): select jos_linkedin.link from jos_linkedin where cat=10

143 (!!!!! 1116.0373687744): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

144 (!!!!! 1209.9742889404): insert into jos_banners_delta values (14615,'2025-04-29 16:11:25','18.219.133.22','view'),(14202,'2025-04-29 16:11:25','18.219.133.22','view'),(14203,'2025-04-29 16:11:25','18.219.133.22','view')

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