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Objectives <p>To describe the reliability of quantitative MRI analysis of flows using 4D-PC (Phase Contrast) compared to 2D-PC flow, without contrast agents.</p> Materials and methods <p>The study was conducted at one centre in a retrospective manner from 2021 to 2023. Eligible patients were adults with repaired Tetralogy of Fallot (rToF) whose follow-up MRI protocol included 4D-PC and 2D-PC, without contrast agent. Assessment involved quantitative measurement of aortic and pulmonary flows on both 4D and 2D. Student’s <i>T</i> was used for comparisons of means and Lin’s concordance correlation coefficient agreement (CCC). A 2nd observer was hired.</p> Results <p>Twenty-six patients were included (50% men, median age of 27 [20; 34]). Scanning mean time was 13 min for 4D and 47 min for non-4D part. Systematic underestimation in pulmonary regurgitation fraction (−10 ± 15%, <i>p</i> = 0.02) and backward volume (−13 ± 18 mL, <i>p</i> = 0.02) was found. Agreement on regurgitant fraction was strong for pulmonary (CCC = 0.75 [0.58–0.86], <i>p</i> &lt; 0.001) and aortic (CCC = 0.91 [0.81–0.95], <i>p</i> &lt; 0.001). Inter-observer showed overall strong results.</p> Conclusion <p>Non-enhanced 4D-PC flow MRI seems to be a reliable method of quantitative flow in rToF patients, but it may underestimate pulmonary regurgitation.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>4D-MRI stands out as an innovative tool for evaluating flows in adults with repaired Tetralogy of Fallot during follow-up</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>4D phase-contrast imaging without the use of contrast agents exhibits robust results and high reproducibility</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>4D-MR is presented as an accurate and versatile tool of cardiac exploration that could improve patient comfort. Minimizing brain gadolinium exposure and reducing scanning time are key objectives of non-enhanced 4D-MR</i>.</p> Graphical Abstract <p></p>

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Non-enhanced MRI flow evaluation using 4D versus 2D phase-contrast in repaired Tetralogy of Fallot adults

  • 期刊论文

  • 发表日期：

    2025年4月17日

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  • Jean Alfred François Champollion,
  • Thomas Senage,
  • Lara Marteau,
  • Jean-Michel Serfaty,
  • Patrice Guerin,
  • Jean-Nicolas Dacher,
  • Karine Warin-Fresse

摘要

Objectives

To describe the reliability of quantitative MRI analysis of flows using 4D-PC (Phase Contrast) compared to 2D-PC flow, without contrast agents.

Materials and methods

The study was conducted at one centre in a retrospective manner from 2021 to 2023. Eligible patients were adults with repaired Tetralogy of Fallot (rToF) whose follow-up MRI protocol included 4D-PC and 2D-PC, without contrast agent. Assessment involved quantitative measurement of aortic and pulmonary flows on both 4D and 2D. Student’s T was used for comparisons of means and Lin’s concordance correlation coefficient agreement (CCC). A 2nd observer was hired.

Results

Twenty-six patients were included (50% men, median age of 27 [20; 34]). Scanning mean time was 13 min for 4D and 47 min for non-4D part. Systematic underestimation in pulmonary regurgitation fraction (−10 ± 15%, p = 0.02) and backward volume (−13 ± 18 mL, p = 0.02) was found. Agreement on regurgitant fraction was strong for pulmonary (CCC = 0.75 [0.58–0.86], p < 0.001) and aortic (CCC = 0.91 [0.81–0.95], p < 0.001). Inter-observer showed overall strong results.

Conclusion

Non-enhanced 4D-PC flow MRI seems to be a reliable method of quantitative flow in rToF patients, but it may underestimate pulmonary regurgitation.

Key Points

Question 4D-MRI stands out as an innovative tool for evaluating flows in adults with repaired Tetralogy of Fallot during follow-up.

Findings 4D phase-contrast imaging without the use of contrast agents exhibits robust results and high reproducibility.

Clinical relevance 4D-MR is presented as an accurate and versatile tool of cardiac exploration that could improve patient comfort. Minimizing brain gadolinium exposure and reducing scanning time are key objectives of non-enhanced 4D-MR.

Graphical Abstract