Non-enhanced MRI flow evaluation using 4D versus 2D phase-contrast in repaired Tetralogy of Fallot adults.
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| Title: | Non-enhanced MRI flow evaluation using 4D versus 2D phase-contrast in repaired Tetralogy of Fallot adults. |
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| Authors: | Champollion, Jean Alfred François1 (AUTHOR) radiologiechampollion@gmail.com, Senage, Thomas2 (AUTHOR), Marteau, Lara1 (AUTHOR), Serfaty, Jean-Michel1 (AUTHOR), Guerin, Patrice2 (AUTHOR), Dacher, Jean-Nicolas3 (AUTHOR), Warin-Fresse, Karine1 (AUTHOR) |
| Source: | European Radiology. Oct2025, Vol. 35 Issue 10, p6313-6322. 10p. |
| Subjects: | Tetralogy of Fallot, Four-dimensional imaging, Pulmonary valve, Phase-contrast microscopy, Cardiac imaging, Quantitative research, Magnetic resonance imaging |
| Abstract: | Objectives: To describe the reliability of quantitative MRI analysis of flows using 4D-PC (Phase Contrast) compared to 2D-PC flow, without contrast agents. Materials and methods: The study was conducted at one centre in a retrospective manner from 2021 to 2023. Eligible patients were adults with repaired Tetralogy of Fallot (rToF) whose follow-up MRI protocol included 4D-PC and 2D-PC, without contrast agent. Assessment involved quantitative measurement of aortic and pulmonary flows on both 4D and 2D. Student's T was used for comparisons of means and Lin's concordance correlation coefficient agreement (CCC). A 2nd observer was hired. Results: Twenty-six patients were included (50% men, median age of 27 [20; 34]). Scanning mean time was 13 min for 4D and 47 min for non-4D part. Systematic underestimation in pulmonary regurgitation fraction (−10 ± 15%, p = 0.02) and backward volume (−13 ± 18 mL, p = 0.02) was found. Agreement on regurgitant fraction was strong for pulmonary (CCC = 0.75 [0.58–0.86], p < 0.001) and aortic (CCC = 0.91 [0.81–0.95], p < 0.001). Inter-observer showed overall strong results. Conclusion: Non-enhanced 4D-PC flow MRI seems to be a reliable method of quantitative flow in rToF patients, but it may underestimate pulmonary regurgitation. Key Points: Question4D-MRI stands out as an innovative tool for evaluating flows in adults with repaired Tetralogy of Fallot during follow-up. Findings4D phase-contrast imaging without the use of contrast agents exhibits robust results and high reproducibility. Clinical relevance4D-MR is presented as an accurate and versatile tool of cardiac exploration that could improve patient comfort. Minimizing brain gadolinium exposure and reducing scanning time are key objectives of non-enhanced 4D-MR. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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| Abstract: | Objectives: To describe the reliability of quantitative MRI analysis of flows using 4D-PC (Phase Contrast) compared to 2D-PC flow, without contrast agents. Materials and methods: The study was conducted at one centre in a retrospective manner from 2021 to 2023. Eligible patients were adults with repaired Tetralogy of Fallot (rToF) whose follow-up MRI protocol included 4D-PC and 2D-PC, without contrast agent. Assessment involved quantitative measurement of aortic and pulmonary flows on both 4D and 2D. Student's T was used for comparisons of means and Lin's concordance correlation coefficient agreement (CCC). A 2nd observer was hired. Results: Twenty-six patients were included (50% men, median age of 27 [20; 34]). Scanning mean time was 13 min for 4D and 47 min for non-4D part. Systematic underestimation in pulmonary regurgitation fraction (−10 ± 15%, p = 0.02) and backward volume (−13 ± 18 mL, p = 0.02) was found. Agreement on regurgitant fraction was strong for pulmonary (CCC = 0.75 [0.58–0.86], p < 0.001) and aortic (CCC = 0.91 [0.81–0.95], p < 0.001). Inter-observer showed overall strong results. Conclusion: Non-enhanced 4D-PC flow MRI seems to be a reliable method of quantitative flow in rToF patients, but it may underestimate pulmonary regurgitation. Key Points: Question4D-MRI stands out as an innovative tool for evaluating flows in adults with repaired Tetralogy of Fallot during follow-up. Findings4D phase-contrast imaging without the use of contrast agents exhibits robust results and high reproducibility. Clinical relevance4D-MR is presented as an accurate and versatile tool of cardiac exploration that could improve patient comfort. Minimizing brain gadolinium exposure and reducing scanning time are key objectives of non-enhanced 4D-MR. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 09387994 |
| DOI: | 10.1007/s00330-025-11542-z |
