MR flow measurements for assessment of the pulmonary, systemic and bronchosystemic circulation: impact of different ECG gating methods and breathing schema.
OBJECTIVE
Different ECG gating techniques are available for MR phase-contrast (PC) flow measurements. Until now no study has reported the impact of different ECG gating techniques on quantitative flow parameters. The goal was to evaluate the impact of the gating method and the breathing schema on the pulmonary, systemic and bronchosystemic circulation.


METHODS
Twenty volunteers were examined (1.5 T) with free breathing phase-contrast flow (PC-flow) measurements with prospective (free-prospective) and retrospective (free-retrospective) ECG gating. Additionally, expiratory breath-hold retrospective ECG gated measurements (bh-retrospective) were performed. Blood flow per minute; peak velocity and time to peak velocity were compared. The clinically important difference between the systemic and pulmonary circulation (bronchosystemic shunt) was calculated.


RESULTS
Blood flow per minute was lowest for free-prospective (6 l/min, pulmonary trunc) and highest for bh-retrospective measurements (6.9 l/min, pulmonary trunc). No clinically significant difference in peak velocity was assessed (82-83 cm/s pulmonary trunc, 109-113 cm/s aorta). Time to peak velocity was shorter for retro-gated free-retrospective and bh-retrospective than for pro-gated free-prospective. The difference between systemic and pulmonary measurements was least for the free-retrospective technique.


CONCLUSIONS
The type of gating has a significant impact on flow measurements. Therefore, it is important to use the same ECG gating method, especially for follow-up examinations. Retrospective ECG gated free breathing measurements allow for the most precise assessment of the bronchosystemic blood flow and should be used in clinical routine.
Ley
Sebastian
S
Department of Pediatric Radiology, Children's Hospital University Heidelberg, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany. ley@gmx.net
Ley-Zaporozhan
Julia
J
Kreitner
Karl-Friedrich
KF
Iliyushenko
Svitlana
S
Puderbach
Michael
M
Hosch
Waldemar
W
Wenz
Heiner
H
Schenk
Jens-Peter
JP
Kauczor
Hans-Ulrich
HU
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011652:Pulmonary Circulation / Q000502:physiology*; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012212:Rheology / Q000379:methods*; D012680:Sensitivity and Specificity