Flow Imaging Clinical Cases Typical Velocities (cm/sec) Pulmonary Artery 70-130 Aorta 100 – 175 Carotid Artery 80 – 120 External Iliac Artery 81 – 120 Carotid Syphon 55 Common Femoral Artery 115 Basilar Artery 40 Superficial Femoral Artery 90 Vertebral Artery 40 Popliteal Artery 70 Sagittal Sinus Vein 10 Peripheral Veins – 10 Qp/Qs: Atrial Septal Defect Trufisp Cine Trufisp Cine ASD not easily seen ASD not easily seen Contrast Bolus First Pass Exam Contrast Bolus First Pass Exam ASD is easily seen ASD is easily seen Dr John Lesser and Dr M Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN Qp/Qs: Atrial Septal Defect Flow Imaging is Perpendicular to Main Pulmonary Artery VENC = 150 cm/sec Flow Imaging is Perpendicular to Aorta VENC = 150 cm/sec Qp/Qs: Atrial Septal Defect pulmonary artery aorta Qp/Qs: Atrial Septal Defect net flow 130 ml pulmonary artery stroke volume 130 ml net flow 80 ml ascending aorta stroke volume 80 ml Qp/Qs: Atrial Septal Defect pulmonary artery ascending aorta • shunt fraction (Qp/Qs ratio) = 131 / 82 = 1.6 • shunt from left atrium to right atrium • known as systemic to pulmonary shunt Pressure Gradient: Pulmonary Valve Stenotic Jet Pulmonary Outflow Short Axis Dr John Lesser and Dr M Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN Pressure Gradient: Pulmonary Valve Stenotic Jet 2 3 Truefisp Cine image through pulmonary valve shows the jet Rephased Flow image with in-plane VENC 500 cm/sec shows the valve Phase Flow image with in-plane VENC 500 cm/sec shows the jet Pressure Gradient: Pulmonary Valve Stenotic Jet 4 Orthogonal slice was placed directly through the jet Truefisp Cine image through pulmonary valve shows the valve & jet Phase Flow image with in-plane VENC 500 cm/sec shows the jet Pressure Gradient: Pulmonary Valve Stenotic Jet • Flow Imaging of Stenotic Jet with Inplane VENC 400 cm/sec • Agrees with Peak Velocity of 400 cm/sec Measured at Cardiac Catheterization Regurgitant Fraction: Aortic Valve Insufficiency TrueFisp Cine Imaging of Aortic Valve Flow Imaging with Through-plane VENC of 150 cm/sec has aliasing (must raise VENC) Dr John Lesser and Dr M Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN Regurgitant Fraction: Aortic Valve Insufficiency VENC -150 to +150 cm/sec has aliasing (before VENC Adjustment, peak velocity 144 wrong) Regurgitant Fraction: Aortic Valve Insufficiency VENC –130 to +170 cm/sec has NO aliasing (after VENC Adjustment, peak velocity 167 correct) Regurgitant Fraction: Aortic Valve Insufficiency regurgitant fraction = 25 / 101 = 25% stroke volume = 76 ml ... Northwestern Hospital, Minneapolis, MN Qp/Qs: Atrial Septal Defect Flow Imaging is Perpendicular to Main Pulmonary Artery VENC = 150 cm/sec Flow Imaging is Perpendicular to Aorta VENC = 150 cm/sec Qp/Qs:... Septal Defect pulmonary artery aorta Qp/Qs: Atrial Septal Defect net flow 130 ml pulmonary artery stroke volume 130 ml net flow 80 ml ascending aorta stroke volume 80 ml Qp/Qs: Atrial Septal Defect... Truefisp Cine image through pulmonary valve shows the jet Rephased Flow image with in-plane VENC 500 cm/sec shows the valve Phase Flow image with in-plane VENC 500 cm/sec shows the jet Pressure