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J Thorac Cardiovasc Surg 1995;110:704-0714
© 1995 Mosby, Inc.
SURGERY FOR ACQUIRED HEART DISEASE |
London, United Kingdom
Supported by CORDA (Coronary Artery Disease Research Association, London) and by the University of California at Davis.
Received for publication June 13, 1994. Accepted for publication Dec. 8, 1994. Address for reprints: Hugo G. Bogren, MD, Department of Radiology, UC Davis Medical Center, 2516 Stockton Blvd., Sacramento, CA 95817.
Abstract
Magnetic resonance imaging with multidirectional cine velocity mapping was used to study relationships between aortic blood flow patterns and the geometry of thoracic aortic aneurysms and grafts. Ten patients with 13 thoracic aortic aneurysms, single or multiple, or grafts (4) participated in the study. The causes of disease were atherosclerosis (4), Marfan's syndrome (2), trauma (1), and unknown (1), and there were two dissections. Spin-echo imaging and cine velocity mapping in 10 mm thick slices with vertical and horizontal velocity encoding were done. Maps of the two velocity components were processed into multiple computer-generated streaks whose orientation and length corresponded to velocity vectors in the chosen plane. The dynamic arrow maps were compared with previously reported aortic arrow maps from normal subjects. The forward flow occupied the entire lumen in the normal aorta in systole and small vortices were only present in the sinuses of Valsalva. Atherosclerotic aneurysms in the ascending aorta were located at the anterior right and had oblique, eccentric jet flows that created a large secondary vortex in the aneurysm. Patients with Marfan's syndrome had a central jet and two large vortices, one on each side. All other aneurysms, dissections, and grafts had irregular flows and vortices not seen in normal subjects. Magnetic resonance imaging with multidirectional velocity mapping is a powerful noninvasive tool to assess morphologic features and disturbed blood flow in aortic aneurysms and grafts. Recognizably altered flow patterns were found to be associated with altered vessel geometry. The significance of this requires further investigation. (J THORACCARDIOVASCSURG1995;110: 704-14)
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