Characterization and Improved Quantification of Left Ventricular Inflow Using Streamline Visualization With 4DFlow MRI in Healthy Controls and Patients After Atrioventricular Septal Defect Correction

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To evaluate trans-left atrioventricular valve (LAVV) blood flow and optimize left ventricular inflow quantification in healthy controls and patients after atrioventricular septal defect (AVSD) correction.

Materials and Methods:

Twenty-five patients after AVSD correction and 25 controls underwent 4DFlow MRI. Using streamline visualization in four- and two-chamber views, inflow direction at early and late filling was defined at the annulus level and at the peak inflow velocity (PIV) level. Trans-LAVV flow volume and velocity were assessed from a static 2D-multiplanar-reformat (MPR), a 4D-MPR tracking LAVV annulus and a 4D-MPR tracking the PIV-level, angulated perpendicular to the inflow.


In patients, on average 9° more laterally directed inflow was found at the PIV-level compared to controls. In controls, 4DFlow velocity mapping with LAVV annulus tracking resulted in lower absolute error with aortic flow (3 (1–8) mL) than with static 2D-MPR (7 (4–16) mL, P = 0.001). In patients, 4D-MPR tracking the PIV-level, resulted in lower absolute error with aortic flow (2 (1–4) mL) than with 4D-MPR LAVV annulus tracking (6 (2–10) mL, P = 0.003).


Streamline visualization of 4DFlow MRI data revealed dynamic trans-LAVV inflow and more lateral flow after AVSD correction. Streamline visualization improved trans-LAVV flow quantification as the positioning and angulation of the measurement plane was optimized, allowing an accurate assessment of left ventricular inflow. J. Magn. Reson. Imaging 2015;41:1512–1520. © 2014 Wiley Periodicals, Inc.

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