title: Does altered aortic flow in marfan syndrome relate to aortic root dilatation?
abstract: To examine possible hemodynamic alterations in adolescent to adult Marfan syndrome (MFS) patients with aortic root dilatation.
  
  
  
  Four-dimensional flow MRI was performed in 20 MFS patients and 12 age-matched normal subjects with a 3T system. The cross-sectional areas of 10 planes along the aorta were segmented for calculating the axial and circumferential wall shear stress (WSSaxial , WSScirc ), oscillatory shear index (OSIaxial , OSIcirc ), and the nonroundness (NR), presenting the asymmetry of segmental WSS. Pearson's correlation analysis was performed to present the correlations between the quantified indices and the body surface area (BSA), aortic root diameter (ARD), and Z score of the ARD. P < 0.05 indicated statistical significance.
  
  
  
  Patients exhibited lower WSSaxial in the aortic root and the WSScirc in the arch (P < 0.05-0.001). MFS patients exhibited higher OSIaxial and OSIcirc in the sinotubular junction and arch, but lower OSIcirc in the descending aorta (all P < 0.05). The NR values were lower in patients (P < 0.05). The WSSaxial or WSScirc exhibited moderate to strong correlations with BSA, ARD, or Z score (R(2)  = 0.50-0.72) in MFS patients.
  
  
  
  The significant differences in the quantified indices, which were associated with BSA, ARD, or Z score, in MFS were opposite to previous reports for younger MFS patients, indicating that altered flows in MFS patients may depend on the disease progress. The possible time dependency of hemodynamic alterations in MFS patients strongly suggests that longitudinal follow-up of 4D Flow is needed to comprehend disease progress. J. Magn. Reson. Imaging 2016;44:500-508.
authors: Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
authors: Hung-Hsuan
authors: HH
authors: Wang
authors: Department of Pediatrics, Taipei Medical University Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Hsin-Hui
authors: HH
authors: Chiu
authors: Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Wen-Yih Isaac
authors: WY
authors: Tseng
authors: Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
authors: Hsu-Hsia
authors: HH
authors: Peng
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008382:Marfan Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: 4D flow; Marfan syndrome; aorta; dilatation; wall shear stress