Dual-VENC 4D Flow MRI Can Detect Abnormal Blood Flow in the Left Atrium That Potentially Causes Thrombosis Formation after Left Upper Lobectomy
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- Nakaza Masatoki
- Department of Radiology, Nippon Medical School
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- Matsumoto Mitsuo
- Department of Respiratory Surgery, Nippon Medical School
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- Sekine Tetsuro
- Department of Radiology, Nippon Medical School Department of Radiology, Nippon Medical School Musashi Kosugi Hopital
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- Inoue Tatsuya
- Department of Respiratory Surgery, Nippon Medical School
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- Ando Takahiro
- Department of Radiology, Nippon Medical School
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- Ogawa Masashi
- Department of Radiology, Nippon Medical School
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- Obara Makoto
- Philips Electronics Japan Ltd
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- Leonowicz Olgierd
- PMOD Technologies LLC
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- Kumita Shinichiro
- Department of Radiology, Nippon Medical School
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- Usuda Jitsuo
- Department of Respiratory Surgery, Nippon Medical School
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Abstract
<p>Purpose: The purpose of the current study was to clarify the blood flow pattern in the left atrium (LA), potentially causing the formation of thrombosis after left upper lobectomy (LUL). The blood flow in the LA was evaluated and compared between LUL patients with and without thrombosis. For the evaluation, we applied highly accelerated 4D flow MRI with dual-velocity encoding (VENC) scheme, which was expected to be able to capture slow flow components in the LA accurately.</p><p>Methods: Eight volunteers and 18 patients subjected to LUL underwent dual-VENC 4D Flow MRI. Eight patients had a history of thrombosis. We measured the blood flow velocity and stasis ratio (proportion in the volume that did not exceed 10 cm/s in any cardiac phase) in the LA and left superior pulmonary vein (LSPV) stump. For visual assessment, the presence of each collision of the blood flow from pulmonary veins and vortex flow in the LA were evaluated. Each acquired value was compared between healthy participants and LUL patients, and in LUL patients with and without thrombosis.</p><p>Results: In LUL patients, blood flow velocity near the inflow part of the left superior pulmonary vein (Lt Upp) and mean velocity in the LA were lower, and stasis ratio in the LA was higher compared with healthy volunteers (Lt Upp 9.10 ± 3.09 vs.13.23 ± 14.19 cm/s, mean velocity in the LA 9.81 ± 2.49 vs. 11.40 ± 1.15 cm/s, and stasis ratio 25.28 ± 18.64 vs. 4.71 ± 3.03%, P = 0.008, 0.037, and < 0.001). There was no significant difference in any quantification values between LUL patients with and without thrombosis. For visual assessment, the thrombus formation was associated with no collision pattern (62.5% vs. 10%, P = 0.019) and not with vortex flow pattern (50% vs. 30%, P = 0.751).</p><p>Conclusion: The net blood flow velocity was not associated with the thrombus formation. In contrast, a specific blood flow pattern, the absence of blood flow collision from pulmonary veins, correlates to the thrombus formation in the LA.</p>
Journal
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- Magnetic Resonance in Medical Sciences
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Magnetic Resonance in Medical Sciences 21 (3), 433-443, 2022
Japanese Society for Magnetic Resonance in Medicine
