Usefulness of 4D Flow MRI in identifying embolic sources in cryptogenic stroke

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K08145
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Akiyama Hisanao 聖マリアンナ医科大学, 医学部, 教授 (50231840)
• Co-Investigator(Kenkyū-buntansha): 小林 泰之 聖マリアンナ医科大学, 医学研究科, 教授 (40285804)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 4D Flow MRI / 潜因性脳梗塞 / atrial cardiopathy / 心原性脳梗塞（塞栓症） / 潜在性心房細動 / 立体的血流プロファイル

Outline of Final Research Achievements

Cryptogenic stroke, the cause of which cannot be identified even after thorough investigation of the embolic source, is thought to be mainly caused by thrombus formation due to covert atrial fibrillation (cardiogenic cerebral embolism) or aortic arch atheroma (aortogenic cerebral embolism), and it is important to differentiate between these two clinical categories because different treatment strategies are required. In this study, we investigated whether the non-invasive method 4D Flow MRI is useful for accurately diagnosing covert atrial fibrillation or atrial cardiopathy as an embolic source. Three-dimensional blood flow profile analysis (streamline analysis and stagnation analysis) using cardiac 4D Flow MRI in the left atrium makes it possible to predict the presence of covert atrial fibrillation, suggesting the possibility that active therapeutic intervention may prevent the recurrence of cardiogenic cerebral embolism.

Free Research Field

脳卒中学

Academic Significance and Societal Importance of the Research Achievements

本研究では4D Flow MRIを用いて左心房や大動脈弓部内での立体的血流プロファイルを解析し可視化・定量化することで血流の淀みや乱流を評価、血栓形成リスクの高い部位を同定し可視化・定量化することで塞栓源を予測できることを示した。非侵襲的検査である4D Flow MRIによる新しい正確な診断法が確立できれば、塞栓機序別の適切な治療介入により脳梗塞の再発低減化が可能となり医療費・介護費の低減に寄与できる。