4D Flow Assessment of Vorticity in Right Ventricular Diastolic Dysfunction

Figures

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  Figure 1. Anti-aliasing algorithm logic chart.

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  Figure 2. Results of the anti-aliasing algorithm on aliased image slices of the aorta and main pulmonary artery (MPA) demonstrating the first, second, third, and fifth iterations of the algorithm on a heavily aliased velocity image. Initially aliased areas are circled in black. No further aliasing is identified by the algorithm beyond the fifth iteration (panel D) and the code terminates, leaving panel D as the final corrected image.

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  Figure 3. Vorticity vectors in a right ventricle (RV) volume during early diastole in a healthy subject. The cuboid encloses the RV volume used for volumetric vorticity integration. The red-scale 4-chamber view is semi-opaque and the short-axis view is fully opaque.

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  Figure 4. Available data used to locate the diastolic tricuspid valve (TV) plane and circular area. (A) 4-chamber cine tissue contrast image at early diastole with a line denoting the TV plane; (B) Velocity vectors at early diastole in the region of the tricuspid valve showing the disk location; (C) a plane colored by velocity magnitude at early diastole showing the spherical clip used to produce the disk; (D) A short-axis tissue contrast cine image showing the TV blood pool at early diastole.

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  Figure 5. Data used in locating a disk in the MPA for MPA flowrate calculations. (A) An axial tissue contrast cine image with velocity vector glyphs and the disk colored in red during systole. Note the proximity of MPA and aortic vertical flow; (B) A slice of velocity data colored by velocity magnitude showing the spherical clip; (C) An axial tissue contrast cine image showing the spherical clip.

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  Figure 6. Process flowchart of postprocessing methodology using 4D Flow and Cine data to calculate spatially integrated vorticity and peak ealy (E) and late (A) wave timing.

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  Figure 7. TV and MPA flowrates and time derivative of LV volume for a normal subject.

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  Figure 8. TV and MPA flowrates and time derivative of LV volume for a subject with RVDD. The RV E-wave peak at 410 ms is chosen by working backwards from the RV A-wave by a time equivalent to the LV diastasis ∆t.

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  Figure 9. Concordance correlation coefficient of vorticity for two observers at multiple vorticity thresholds. Concordance increases with increasing vorticity threshold until a threshold of roughly 0.04 L/s.

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  Figure 10. Right heart vorticity during peak early diastole for a normal subject thresholded at (A) 0.01 s−1, (B) 0.03 s−1, (C) 0.04 s−1, and (D) 0.05 s−1. Vector glyphs are colored by vorticity magnitude and a grayscale 4-Chamber cine image plane is shown for spatial reference.