title: Flow-sensitive four-dimensional cine magnetic resonance imaging for offline blood flow quantification in multiple vessels: a validation study.
abstract: OBJECTIVE
  To further validate the quantitative use of flow-sensitive four-dimensional velocity encoded cine magnetic resonance imaging (4D VEC MRI) for simultaneously acquired venous and arterial blood flow in healthy volunteers and for abnormal flow in patients with congenital heart disease.
  
  
  METHODS
  Stroke volumes (SV) obtained in arterial and venous thoracic vessels were compared between standard two-dimensional (2D), 4D VEC MRI with and without respiratory navigator gating (gated/nongated) in volunteers (n = 7). In addition, SV and regurgitation fractions (RF) measured in aorta or pulmonary trunk of patients with malformed and/or insufficient valves (n = 10) were compared between 2D and nongated 4D VEC MRI methods.
  
  
  RESULTS
  In volunteers and patients, Bland-Altman tests showed excellent agreement between 2D, gated, and nongated 4D VEC MRI obtained quantitative blood flow measurements. The bias between 2D and gated 4D VEC MRI was <0.5 mL for SV; between 2D and nongated 4D VEC MRI the bias was <0.7 mL for SV and <1% for RF.
  
  
  CONCLUSIONS
  Blood flow can be quantified accurately in arterial, venous, and pathological flow conditions using 4D VEC MRI. Nongated 4D VEC MRI has the potential to be suited for clinical use in patients with congenital heart disease who require flow acquisitions in multiple vessels.
authors.affiliation: Deutsches Herzzentrum Berlin, Unit of Cardiovascular Imaging, Department of Congenital Heart Disease and Paediatric Cardiology, Berlin, Germany. snordmeyer@dhzb.de
authors.forename: Sarah
authors.initials: S
authors.lastname: Nordmeyer
authors.forename: Eugénie
authors.initials: E
authors.lastname: Riesenkampff
authors.forename: Gérard
authors.initials: G
authors.lastname: Crelier
authors.forename: Alireza
authors.initials: A
authors.lastname: Khasheei
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
authors.forename: Titus
authors.initials: T
authors.lastname: Kuehne
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D011651:Pulmonary Artery / Q000502:physiology; D011667:Pulmonary Veins / Q000502:physiology; D012016:Reference Values; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D014683:Vena Cava, Superior / Q000502:physiology; D055815:Young Adult