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Four-dimensional flow cardiovascular magnetic resonance in tetralogy of Fallot: a systematic review
Journal of Cardiovascular Magnetic Resonance ( IF 6.4 ) Pub Date : 2021-05-20 , DOI: 10.1186/s12968-021-00745-0
Ayah Elsayed 1 , Kathleen Gilbert 2 , Miriam Scadeng 1 , Brett R Cowan 3 , Kuberan Pushparajah 4 , Alistair A Young 1, 4
Affiliation  

Patients with repaired Tetralogy of Fallot (rTOF) often develop cardiovascular dysfunction and require regular imaging to evaluate deterioration and time interventions such as pulmonary valve replacement. Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) enables detailed assessment of flow characteristics in all chambers and great vessels. We performed a systematic review of intra-cardiac 4D flow applications in rTOF patients, to examine clinical utility and highlight optimal methods for evaluating rTOF patients. A comprehensive literature search was undertaken in March 2020 on Google Scholar and Scopus. A modified version of the Critical Appraisal Skills Programme (CASP) tool was used to assess and score the applicability of each study. Important clinical outcomes were assessed including similarities and differences. Of the 635 articles identified, 26 studies met eligibility for systematic review. None of these were below 59% applicability on the modified CASP score. Studies could be broadly classified into four groups: (i) pilot studies, (ii) development of new acquisition methods, (iii) validation and (vi) identification of novel flow features. Quantitative comparison with other modalities included 2D phase contrast CMR (13 studies) and echocardiography (4 studies). The 4D flow study applications included stroke volume (18/26;69%), regurgitant fraction (16/26;62%), relative branch pulmonary artery flow(4/26;15%), systolic peak velocity (9/26;35%), systemic/pulmonary total flow ratio (6/26;23%), end diastolic and end systolic volume (5/26;19%), kinetic energy (5/26;19%) and vorticity (2/26;8%). 4D flow CMR shows potential in rTOF assessment, particularly in retrospective valve tracking for flow evaluation, velocity profiling, intra-cardiac kinetic energy quantification, and vortex visualization. Protocols should be targeted to pathology. Prospective, randomized, multi-centered studies are required to validate these new characteristics and establish their clinical use.

中文翻译:

法洛四联症四维血流心血管磁共振:系统评价

法洛四联症 (rTOF) 修复后的患者通常会出现心血管功能障碍,需要定期进行影像学检查以评估病情恶化情况并及时采取干预措施,例如肺动脉瓣置换术。四维血流心血管磁共振(4D 血流 CMR)能够详细评估所有腔室和大血管的血流特征。我们对 rTOF 患者的心内 4D 血流应用进行了系统评价,以检查临床实用性并强调评估 rTOF 患者的最佳方法。2020 年 3 月,我们在 Google Scholar 和 Scopus 上进行了全面的文献检索。使用批判性评估技能计划(CASP)工具的修改版本来评估和评分每项研究的适用性。评估了重要的临床结果,包括相似点和差异。在确定的 635 篇文章中,26 篇研究符合系统评价的资格。这些在修改后的 CASP 评分上的适用性都不低于 59%。研究可大致分为四组:(i)试点研究,(ii)新采集方法的开发,(iii)验证和(vi)新颖流动特征的识别。与其他方式的定量比较包括 2D 相差 CMR(13 项研究)和超声心动图(4 项研究)。4D 血流研究应用包括每搏输出量 (18/26;69%)、反流分数 (16/26;62%)、相对肺动脉分支血流 (4/26;15%)、收缩期峰值速度 (9/26;15%)、收缩期峰值速度 (9/26;15%)。 35%)、全身/肺总流量比(6/26;23%)、舒张末期和收缩末期容积(5/26;19%)、动能(5/26;19%)和涡度(2/26 ;8%)。4D 血流 CMR 在 rTOF 评估中显示出潜力,特别是在用于血流评估的回顾性瓣膜跟踪、速度分析、心脏内动能量化和涡流可视化方面。方案应针对病理学。需要进行前瞻性、随机、多中心研究来验证这些新特征并确定其临床用途。
更新日期:2021-05-20
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