68-year-old patient presented with
progressive shortness of breath and
fatigue. He had noticed decreased
exercise tolerance. The patient had a
history of congenital aortic stenosis
status post-Ross procedure. He has
undergone routine follow up for known
neoaortic root dilatation.
Evaluating Pulmonic Stenosis and Aortic Regurgitation
with ViosWorks/4D Flow
Case courtesy of Dr. Melany Atkins, Fairfax Radiological Consultants, Fairfax, VA.
Multiplanar, multisequence 3.0T
imaging was performed utilizing SA
FIESTA, HLA FIESTA, SA T2 DIR, and
2D Phase contrast imaging through
the main PA and aorta. Dedicated
Vios Works/4D Flow performed after
administration of 10 cc of intravenous
ABLAVAR® prior to traditional MRA
imaging. Post processing via Arterys
(Vios Works) cloud-based software.
Figure 6. 3D image from the 4D Flow dataset demonstrating
pulmonic stenosis at the level of the pulmonic valve
Figure 5. Oblique view along the long axis of the pulmonary out;ow
tract and main pulmonary artery demonstrating pulmonic stenosis.
The adjacent trilea;et aortic valve autograft demonstrates normal
Figure 4. 3D image from the 4D Flow dataset demonstrating the
ascending aorta and pulmonary out;ow tract/main pulmonary
arteries with streamline overlay. The streamline overlay illustrates
Figure 7. 3D image from the 4D Flow dataset demonstrating
post-surgical change associated with Ross procedure. Mild aortic
regurgitation from the aortic valve autograft. Mild aneurysmal
dilatation of the ascending thoracic aorta.
4D Flow Parameters
Flip angle: 15 degrees
TR: 4. 70
TE: 2. 14
Venc: 300 cm/sec
Scan time: 8 min, 50 sec