Optimal Plane Selection for Measuring Post-prandial Blood Flow Increase within the Superior Mesenteric Artery: Analysis Using 4D Flow and Computational Fluid Dynamics

Masataka Sugiyama; Yasuo Takehara; Masanori Kawate; Naoki Ooishi; Masaki Terada; Haruo Isoda; Harumi Sakahara; Shinji Naganawa; Kevin M Johnson; Oliver Wieben; Tetsuya Wakayama; Atsushi Nozaki; Hiroyuki Kabasawa

doi:10.2463/mrms.mp.2019-0089

Optimal Plane Selection for Measuring Post-prandial Blood Flow Increase within the Superior Mesenteric Artery: Analysis Using 4D Flow and Computational Fluid Dynamics

Magn Reson Med Sci. 2020 Dec 1;19(4):366-374. doi: 10.2463/mrms.mp.2019-0089. Epub 2020 Jan 31.

Authors

Masataka Sugiyama¹, Yasuo Takehara¹, Masanori Kawate², Naoki Ooishi², Masaki Terada³, Haruo Isoda⁴, Harumi Sakahara⁵, Shinji Naganawa⁶, Kevin M Johnson^{7

8}, Oliver Wieben^{7

8}, Tetsuya Wakayama⁹, Atsushi Nozaki⁹, Hiroyuki Kabasawa⁹

Affiliations

¹ Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine.
² Department of Radiological Technology, Hamamatsu University Hospital.
³ Department of Radiological Technology, Iwata Municipal Hospital.
⁴ Brain & Mind Research Center, Nagoya University.
⁵ Department of Diagnostic Radiology & Nuclear Medicine, Hamamatsu University School of Medicine.
⁶ Department of Radiology, Nagoya University Graduate School of Medicine.
⁷ Department of Medical Physics, University of Wisconsin.
⁸ Department of Radiology, University of Wisconsin.
⁹ GE Healthcare, Global Applied Science Laboratory.

Abstract

Purpose: 2D cine phase contrast (PC)-MRI is a standard velocimetry for the superior mesenteric artery (SMA); however, the optimal localization of the measurement plane has never been fully discussed previously. The purpose of this Institutional Review Board approved prospective and single arm study is to test whether flow velocimetry of the SMA with combined use of 2D cine PC-MRI and meal challenge is dependent on the localizations of the measurement planes and to seek optimal section for velocimetry.

Methods: Seven healthy volunteers underwent cardiac phase resolved ECG gated 2D cine PC-MRI pre- and 30 min post-meal challenge at three measurement planes: proximal, curved mid section and distal straight section of the SMA at 3T. 4D Flow using 3D cine PC-MRI with vastly undersampled isotropic projection imaging (PC VIPR) was also performed right after 2D cine PC-MRI to delineate the flow dynamics within the SMA using streamline analysis. Two radiologists measured flow velocities, and rated the appearances of the abnormal flow in the SMA on streamlines derived from the 4D Flow and the computational fluid dynamics (CFD).

Results: 2D cine PC-MRI measured increased temporally averaged flow velocity (mm/s) after the meal challenge only in the proximal (129.3 vs. 97.8, P = 0.0313) and distal section (166.9 vs. 96.2, P = 0.0313), not in the curved mid section (113.1 vs. 85.5, P = 0.0625). The average velocities were highest and their standard errors (8.5-26.5) were smallest at the distal straight section both before and after the meal challenge as compared with other sections. The streamline analysis depicted more frequent appearances of vertical or helical flow in the curved mid section both on 4D Flow and CFD (κ: 0.27-0.68).

Conclusion: SMA velocimetry with 2D cine PC-MRI was dependent on the localization of the measurement planes. Distal straight section, not in the curved mid section is recommended for MR velocimetry.

Keywords: 4D Flow; flow measurement; phase contrast image; post-prandial hyperemia; superior mesenteric artery.

MeSH terms

Adult
Blood Flow Velocity*
Female
Healthy Volunteers
Humans
Hydrodynamics*
Imaging, Three-Dimensional*
Magnetic Resonance Imaging, Cine*
Male
Mesenteric Artery, Superior / diagnostic imaging*
Middle Aged
Postprandial Period
Prospective Studies
Rheology
Young Adult