Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla.
OBJECTIVE
It was the aim to analyse the impact of age, aortic arch geometry, and size on secondary flow patterns such as helix and vortex flow derived from flow-sensitive magnetic resonance imaging (4D PC-MRI).


METHODS
62 subjects (age range = 20-80 years) without circumscribed pathologies of the thoracic aorta (ascending aortic (AAo) diameter: 3.2 ± 0.6 cm [range 2.2-5.1]) were examined by 4D PC-MRI after IRB-approval and written informed consent. Blood flow visualisation based on streamlines and time-resolved 3D particle traces was performed. Aortic diameter, shape (gothic, crook-shaped, cubic), angle, and age were correlated with existence and extent of secondary flow patterns (helicity, vortices); statistical modelling was performed.


RESULTS
Helical flow was the typical pattern in standard crook-shaped aortic arches. With altered shapes and increasing age, helicity was less common. AAo diameter and age had the highest correlation (r = 0.69 and 0.68, respectively) with number of detected vortices. None of the other arch geometric or demographic variables (for all, P ≥ 0.177) improved statistical modelling.


CONCLUSIONS
Substantially different secondary flow patterns can be observed in the normal thoracic aorta. Age and the AAo diameter were the parameters correlating best with presence and amount of vortices. Findings underline the importance of age- and geometry-matched control groups for haemodynamic studies.


CONCLUSIONS
• Secondary blood flow patterns (helices, vortices) are commonly observed in the aorta • Secondary flow patterns predominantly depend on patient age and aortic diameter • Geometric factors show a lesser impact on blood flow patterns than age and diameter • Future analyses of flow patterns should incorporate age- and diameter dependencies.
Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Haus 40, 23538 Lübeck, Germany. alex.frydrychowicz@uksh.de
Alex
A
Frydrychowicz
Alexander
A
Berger
Alejandro
A
Munoz Del Rio
Maximilian F
MF
Russe
Jelena
J
Bock
Andreas
A
Harloff
Michael
M
Markl
D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology* / Q000502:physiology*; D001013:Aorta, Thoracic / Q000033:anatomy & histology* / Q000502:physiology*; D001783:Blood Flow Velocity / Q000502:physiology; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015233:Models, Statistical; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult