Key result
The EOA AST method using 4D Phase-Contrast MRI is suitable for assessing Bileaflet Mechanical Heart Valve function, with optimal computation 8 to 10 mm after the metallic blurring artefact.
Why the study?
To define the effective orifice area derived from the acoustic source term method from 4D Phase-Contrast MRI data to provide a reference for assessing MRI valvular prostheses.
Does the acoustic source term method from 4D Phase-Contrast MRI accurately assess the Effective Orifice Area of Bileaflet Mechanical Heart Valves in vitro?
Does the acoustic source term method from 4D Phase-Contrast MRI accurately assess the Effective Orifice Area of Bileaflet Mechanical Heart Valves in vitro?
The acoustic source term method using 4D Phase-Contrast MRI is suitable for assessing Bileaflet Mechanical Heart Valve function in vitro, providing a reference for clinical translation.
In vitro support for 4D PC-MRI EOA assessment of bileaflet valves; leaves open clinical translation pending in vivo validation.
Background: This work aims at defining the Effective Orifice Area (EOA) derived from the acoustic source term (AST) method from 4D Phase-Contrast MRI data to provide a reference for the assessment of MRI valvular prostheses as part of a comprehensive cardiac exam. Methods: Three different Bileaflet Mechanical Heart Valves (BMHV) and a dysfunctional BMHV were tested in-vitro using 4D Phase-Contrast MRI and a numerical design of the experimental study was performed, including the influence of internal diameter, stroke volume, and heart rate. The EOA AST was computed based on the MRI 4D Phase-Contrast acquisition. Results: EOAAST values vary by 15 mm from the BMHV center and should be computed between 8 to 10 mm after the metallic “blurring” artefact (ranging from 18.9 to 23.4 mm from the BMHV). EOAAST values were found to be lower compared with numerical results in the appropriate plane. Detection of the BMHV dysfunction by continuity equation computed from 4D flow acquisition is limited based on EOAAST computations, while EOAc and velocities after the valves could more directly highlight a blocked leaflet. Conclusion: This multi-disciplinary study demonstrates the suitability of the EOA AST method to assess BMHV function using MRI. Translation to the clinic is feasible using an optimized 2D Phase-Contrast flow stack or a 4D Phase-Contrast minimal volume based on the recommendations provided.
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Evin et al. (2022) studied Bileaflet Mechanical Heart Valve assessment (n=4). 4D Phase-Contrast MRI with Acoustic Source Term (AST) method vs. Numerical results was evaluated on Effective Orifice Area (EOA) derived from the acoustic source term (AST) method. The EOA AST method using 4D Phase-Contrast MRI is suitable for assessing Bileaflet Mechanical Heart Valve function, with optimal computation 8 to 10 mm after the metallic blurring artefact.
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