الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Tetralogy of Fallot is the most common congenital cyanotic heart disease. Primary repair in infancy is standard care. Surgical advances have resulted in improved long-term survival with a growing number of adult patients. However, residual anatomic and hemodynamic defects are almost always present necessitating lifelong follow up of repaired TOF. CMR plays a central role on the evaluation of patients and is considered the gold standard for the assessment of RV volumes and function as well as the quantification of PR.(27)
4D flow CMR has emerged as a development in the field of MRI that enables the comprehensive study of flow. It involves the acquisition of a three-dimensional time-resolved PC MRI volume with velocity-encoding in all three spatial directions along the cardiac cycle. This has enabled not only flow quantification, but also visualization of multidirectional flow patterns as well as the study of advanced hemodynamic parameters including WSS. This has given more insight into altered flow dynamics which is important in understanding the underlying mechanisms in various cardiovascular disease processes.(47)
The aim of this study was to quantify pulmonary blood flow in patients with repaired TOF using 4D flow CMR in comparison with 2D-PC CMR, as well as to describe the patterns of pulmonary blood flow and wall shear stress in the pulmonary arteries.
The study included 30 patients with repaired tetralogy of Fallot referred for further CMR evaluation of RV volumes, RV function and PR fraction. Patients with permanent pacemakers or implantable cardiac defibrillators were excluded. The study also included 11 healthy volunteers.
The CMR study protocol included SSFP cine axial images, 3D-SSFP sequence, 2D-PC CMR and 4D flow CMR sequences. No contrast agent was administered. Data pre-processing included phase offset correction and background noise filtering. Data analysis included flow visualization, flow quantification and WSS estimation in the MPA and the ascending aorta.