Right and left ventricular function and flow quantification in pediatric patients with repaired tetralogy of Fallot using four-dimensional flow magnetic resonance imaging

Xiaofen Yao; Liwei Hu; Yafeng Peng; Fei Feng; Rongzhen Ouyang; Weihui Xie; Qian Wang; Aimin Sun; Yumin Zhong

doi:10.1186/s12880-021-00693-2

Right and left ventricular function and flow quantification in pediatric patients with repaired tetralogy of Fallot using four-dimensional flow magnetic resonance imaging

BMC Med Imaging. 2021 Oct 31;21(1):161. doi: 10.1186/s12880-021-00693-2.

Authors

Xiaofen Yao¹, Liwei Hu¹, Yafeng Peng¹, Fei Feng², Rongzhen Ouyang¹, Weihui Xie¹, Qian Wang¹, Aimin Sun¹, Yumin Zhong³

Affiliations

¹ Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, No. 1678 Dongfang Road, Shanghai, 200127, China.
² AI Imaging, GE Healthcare, No. 1 Huatuo Road, Shanghai, 201203, China.
³ Department of Radiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, No. 1678 Dongfang Road, Shanghai, 200127, China. zyumin2002@163.com.

Abstract

Background: To assess the accuracy and reproducibility of right ventricular (RV) and left ventricular (LV) function and flow measurements in children with repaired tetralogy of Fallot (rTOF) using four-dimensional (4D) flow, compared with conventional two-dimensional (2D) magnetic resonance imaging (MRI) sequences.

Methods: Thirty pediatric patients with rTOF were retrospectively enrolled to undergo 2D balanced steady-state free precession cine (2D b-SSFP cine), 2D phase contrast (PC), and 4D flow cardiac MRI. LV and RV volumes and flow in the ascending aorta (AAO) and main pulmonary artery (MPA) were quantified. Pearson's or Spearman's correlation tests, paired t-tests, the Wilcoxon signed-rank test, Bland-Altman analysis, and intraclass correlation coefficients (ICC) were performed.

Results: The 4D flow scan time was shorter compared with 2D sequences (P < 0.001). The biventricular volumes between 4D flow and 2D b-SSFP cine had no significant differences (P > 0.05), and showed strong correlations (r > 0.90, P < 0.001) and good consistency. The flow measurements of the AAO and MPA between 4D flow and 2D PC showed moderate to good correlations (r > 0.60, P < 0.001). There was good internal consistency in cardiac output. There was good intraobserver and interobserver biventricular function agreement (ICC > 0.85).

Conclusions: RV and LV function and flow quantification in pediatric patients with rTOF using 4D flow MRI can be measured accurately and reproducibly compared to those with conventional 2D sequences.

Keywords: 4D flow; Cardiac magnetic resonance; Repaired tetralogy of Fallot.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Flow Velocity
Cardiac-Gated Imaging Techniques
Child
Female
Heart Ventricles / diagnostic imaging*
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging, Cine / methods*
Male
Reproducibility of Results
Retrospective Studies
Tetralogy of Fallot / surgery*
Ventricular Function, Left
Ventricular Function, Right