Key result
Inner volume excitation improves radial 4D flow MRI quality vs. standard excitation in obese patients.
Why the study?
Abdominal 4D flow MRI presents technical challenges in obese patients due to artifacts originating from adipose signals.
Do fat mitigation strategies (IVE or FS) improve image quality and flow quantification in radial 4D flow MRI of obese subjects compared to standard slab selective excitation?
Cross-Sectional (n=15)
Do fat mitigation strategies (IVE or FS) improve image quality and flow quantification in radial 4D flow MRI of obese subjects compared to standard slab selective excitation?
Inner volume excitation is an effective fat mitigation strategy that improves image quality and flow quantification in abdominal radial 4D flow MRI of obese patients.
Answers are grounded in this paper and cite their sources.
IVE may enhance abdominal 4D flow MRI quality in obese patients; hypothesis-generating and requires prospective validation before clinical adoption.
PURPOSE: This study addresses the challenges in obtaining abdominal 4D flow MRI of obese patients. We aimed to evaluate spectral saturation and inner volume excitation as methods to mitigating artifacts originating from adipose signals, with the goal of enhancing image quality and improving quantification. METHODS: Radial 4D flow MRI acquisitions with fat mitigation (inner volume excitation [IVE] and intermittent fat saturation [FS]) were compared to a standard slab selective excitation (SSE) in a test-retest study of 15 obese participants. IVE selectively excited a cylindrical region of interest, avoiding contamination from peripheral adipose tissue, while FS globally suppressed fat based on spectral selection. Acquisitions were evaluated qualitatively based on expert ratings and quantitatively based on conservation of mass, test-retest repeatability, and a divergence free quality metric. Errors were evaluated statistically using the absolute and relative errors, regression, and Bland-Altman analysis. RESULTS: IVE demonstrated superior performance quantitatively in the conservation of mass analysis in the portal vein, with higher correlation and lower bias in regression analysis. IVE also produced flow fields with the lowest divergence error and was rated best in overall image quality, delineating small vessels, and producing the least streaking artifacts. Evaluation results did not differ significantly between FS and SSE. Test-retest reproducibility was similarly high for all sequences, with data suggesting biological variations dominate the technical variability. CONCLUSION: IVE improved hemodynamic assessment of radial 4D flow MRI in the abdomen of obese participants while FS did not lead to significant improvements in image quality or flow metrics.
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Shamim et al. (2023) conducted a cross-sectional in Obesity (n=15). Inner volume excitation (IVE) and intermittent fat saturation (FS) vs. Standard slab selective excitation (SSE) was evaluated on Conservation of mass, test-retest repeatability, and a divergence free quality metric. Inner volume excitation improved hemodynamic assessment and image quality of radial 4D flow MRI in 15 obese participants compared to standard excitation, whereas fat saturation did not.
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