Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease

Mauricio S. Galizia; Alex Barker; Yihua Liao; Jeremy Collins; James Carr; Mary M. McDermott; Michael Markl

doi:10.1007/s00330-013-3081-x

Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease

Mauricio S. Galizia, Alex Barker, Yihua Liao, Jeremy Collins, James Carr, Mary M. McDermott, Michael Markl

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Objectives: To investigate the influence of atherosclerotic plaques on femoral haemodynamics assessed by two-dimensional (2D) phase-contrast (PC) magnetic resonance imaging (MRI) with three-directional velocity encoding. Methods: During 1 year, patients with peripheral artery disease and an ankle brachial index <1.00 were enrolled. After institutional review board approval and written informed consent, 44 patients (age, 70±12 years) underwent common femoral artery MRI. Patients with contra-indications for MRI were excluded. Sequences included 2D time-of-flight, proton-density, T1-weighted and T2-weighted MRI. Electrocardiogram (ECG)-gated 2D PC-MRI with 3D velocity encoding was acquired. A radiologist classified images in five categories. Blood flow, velocity and wall shear stress (WSS) along the vessel circumference were quantified from the PC-MRI data. Results: The acquired images were of good quality for interpretation. There were no image quality problems related to poor ECG-gating or slice positioning. Velocities, oscillatory shear stress and total flow were similar between patients with normal arteries and wall thickening/plaque. Patients with plaques demonstrated regionally increased peak systolic WSS and enhanced WSS eccentricity. Conclusions: Combined multi-contrast morphological imaging of the peripheral arterial wall with PC-MRI with three-directional velocity encoding is a feasible technique. Further study is needed to determine whether flow is an appropriate marker for altered endothelial cell function, vascular remodelling and plaque progression. Key Points: • Femoral plaques are associated with altered dynamics of peripheral blood flow. • Multi-contrast MRI can investigate the presence and type of atherosclerotic plaques. • Three-dimensional velocity-encoding phase-contrast MRI can investigate flow and wall shear stress. • Atherosclerotic peripheral arteries demonstrate increased systolic velocities and wall shear stress.

Original language	English
Pages (from-to)	850-856
Number of pages	7
Journal	European Radiology
Volume	24
Issue number	4
DOIs	https://doi.org/10.1007/s00330-013-3081-x
State	Published - Apr 2014
Externally published	Yes

Keywords

Blood flow
Peripheral arterial disease
Phase-contrast MRI
Plaque
Wall shear stress

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10.1007/s00330-013-3081-x

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@article{9b9bafed00824c8dbbe9376dfb40887f,

title = "Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease",

abstract = "Objectives: To investigate the influence of atherosclerotic plaques on femoral haemodynamics assessed by two-dimensional (2D) phase-contrast (PC) magnetic resonance imaging (MRI) with three-directional velocity encoding. Methods: During 1 year, patients with peripheral artery disease and an ankle brachial index <1.00 were enrolled. After institutional review board approval and written informed consent, 44 patients (age, 70±12 years) underwent common femoral artery MRI. Patients with contra-indications for MRI were excluded. Sequences included 2D time-of-flight, proton-density, T1-weighted and T2-weighted MRI. Electrocardiogram (ECG)-gated 2D PC-MRI with 3D velocity encoding was acquired. A radiologist classified images in five categories. Blood flow, velocity and wall shear stress (WSS) along the vessel circumference were quantified from the PC-MRI data. Results: The acquired images were of good quality for interpretation. There were no image quality problems related to poor ECG-gating or slice positioning. Velocities, oscillatory shear stress and total flow were similar between patients with normal arteries and wall thickening/plaque. Patients with plaques demonstrated regionally increased peak systolic WSS and enhanced WSS eccentricity. Conclusions: Combined multi-contrast morphological imaging of the peripheral arterial wall with PC-MRI with three-directional velocity encoding is a feasible technique. Further study is needed to determine whether flow is an appropriate marker for altered endothelial cell function, vascular remodelling and plaque progression. Key Points: • Femoral plaques are associated with altered dynamics of peripheral blood flow. • Multi-contrast MRI can investigate the presence and type of atherosclerotic plaques. • Three-dimensional velocity-encoding phase-contrast MRI can investigate flow and wall shear stress. • Atherosclerotic peripheral arteries demonstrate increased systolic velocities and wall shear stress.",

keywords = "Blood flow, Peripheral arterial disease, Phase-contrast MRI, Plaque, Wall shear stress",

author = "Galizia, {Mauricio S.} and Alex Barker and Yihua Liao and Jeremy Collins and James Carr and McDermott, {Mary M.} and Michael Markl",

note = "Funding Information: Supported by funding from the National Heart, Lung, and Blood Institute (R01-HL083064, R01HL115828 and R01-HL109244); NUCATS Institute NIH grant UL1RR025741, and the Northwestern Memorial Foundation Dixon Translational Research Grants Initiative; American Heart Association Scientist Development Grant 13SDG14360004.",

year = "2014",

month = apr,

doi = "10.1007/s00330-013-3081-x",

language = "English",

volume = "24",

pages = "850--856",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Verlag",

number = "4",

}

TY - JOUR

T1 - Wall morphology, blood flow and wall shear stress

T2 - MR findings in patients with peripheral artery disease

AU - Galizia, Mauricio S.

AU - Barker, Alex

AU - Liao, Yihua

AU - Collins, Jeremy

AU - Carr, James

AU - McDermott, Mary M.

AU - Markl, Michael

N1 - Funding Information: Supported by funding from the National Heart, Lung, and Blood Institute (R01-HL083064, R01HL115828 and R01-HL109244); NUCATS Institute NIH grant UL1RR025741, and the Northwestern Memorial Foundation Dixon Translational Research Grants Initiative; American Heart Association Scientist Development Grant 13SDG14360004.

PY - 2014/4

Y1 - 2014/4

N2 - Objectives: To investigate the influence of atherosclerotic plaques on femoral haemodynamics assessed by two-dimensional (2D) phase-contrast (PC) magnetic resonance imaging (MRI) with three-directional velocity encoding. Methods: During 1 year, patients with peripheral artery disease and an ankle brachial index <1.00 were enrolled. After institutional review board approval and written informed consent, 44 patients (age, 70±12 years) underwent common femoral artery MRI. Patients with contra-indications for MRI were excluded. Sequences included 2D time-of-flight, proton-density, T1-weighted and T2-weighted MRI. Electrocardiogram (ECG)-gated 2D PC-MRI with 3D velocity encoding was acquired. A radiologist classified images in five categories. Blood flow, velocity and wall shear stress (WSS) along the vessel circumference were quantified from the PC-MRI data. Results: The acquired images were of good quality for interpretation. There were no image quality problems related to poor ECG-gating or slice positioning. Velocities, oscillatory shear stress and total flow were similar between patients with normal arteries and wall thickening/plaque. Patients with plaques demonstrated regionally increased peak systolic WSS and enhanced WSS eccentricity. Conclusions: Combined multi-contrast morphological imaging of the peripheral arterial wall with PC-MRI with three-directional velocity encoding is a feasible technique. Further study is needed to determine whether flow is an appropriate marker for altered endothelial cell function, vascular remodelling and plaque progression. Key Points: • Femoral plaques are associated with altered dynamics of peripheral blood flow. • Multi-contrast MRI can investigate the presence and type of atherosclerotic plaques. • Three-dimensional velocity-encoding phase-contrast MRI can investigate flow and wall shear stress. • Atherosclerotic peripheral arteries demonstrate increased systolic velocities and wall shear stress.

AB - Objectives: To investigate the influence of atherosclerotic plaques on femoral haemodynamics assessed by two-dimensional (2D) phase-contrast (PC) magnetic resonance imaging (MRI) with three-directional velocity encoding. Methods: During 1 year, patients with peripheral artery disease and an ankle brachial index <1.00 were enrolled. After institutional review board approval and written informed consent, 44 patients (age, 70±12 years) underwent common femoral artery MRI. Patients with contra-indications for MRI were excluded. Sequences included 2D time-of-flight, proton-density, T1-weighted and T2-weighted MRI. Electrocardiogram (ECG)-gated 2D PC-MRI with 3D velocity encoding was acquired. A radiologist classified images in five categories. Blood flow, velocity and wall shear stress (WSS) along the vessel circumference were quantified from the PC-MRI data. Results: The acquired images were of good quality for interpretation. There were no image quality problems related to poor ECG-gating or slice positioning. Velocities, oscillatory shear stress and total flow were similar between patients with normal arteries and wall thickening/plaque. Patients with plaques demonstrated regionally increased peak systolic WSS and enhanced WSS eccentricity. Conclusions: Combined multi-contrast morphological imaging of the peripheral arterial wall with PC-MRI with three-directional velocity encoding is a feasible technique. Further study is needed to determine whether flow is an appropriate marker for altered endothelial cell function, vascular remodelling and plaque progression. Key Points: • Femoral plaques are associated with altered dynamics of peripheral blood flow. • Multi-contrast MRI can investigate the presence and type of atherosclerotic plaques. • Three-dimensional velocity-encoding phase-contrast MRI can investigate flow and wall shear stress. • Atherosclerotic peripheral arteries demonstrate increased systolic velocities and wall shear stress.

KW - Blood flow

KW - Peripheral arterial disease

KW - Phase-contrast MRI

KW - Plaque

KW - Wall shear stress

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DO - 10.1007/s00330-013-3081-x

M3 - Article

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JO - European Radiology

JF - European Radiology

IS - 4

ER -

Wall morphology, blood flow and wall shear stress: MR findings in patients with peripheral artery disease

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Keywords

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