4D Flow MRI-Derived Hemodynamic Parameters Related to Growth in Acute Type B Aortic Dissections

Abstract

Motivation: In type B aortic dissections (TBAD), surgical outcomes often worsen as the flap stiffens. Earlier intervention (i.e., acute phase) would require prediction of aortic growth to identify high-risk patients, which has not yet been investigated in acute TBADs. Goal(s): We aimed to identify possible hemodynamic markers of aortic growth from 4D flow MRI data in acute TBAD subjects. Approach: From the 4D flow data we estimated various hemodynamic metrics. Results: Peak entry tear velocity, false lumen retrograde flow pre-entry tear, and forward flow post-entry tear were higher in growth cases. We also demonstrate the feasibility of collecting 4D flow MRI from acute patients. Impact: As the first study focused on in vivo hemodynamics of acute type B aortic dissections (TBAD), we aimed to identify possible metrics for predicting aortic growth. Ultimately, stratifying risk in acute TBAD patients would enable preemptive treatment and improve outcomes.