{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T02:34:15Z","timestamp":1768271655061,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013711","name":"Bayer Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL169780"],"award-info":[{"award-number":["R01HL169780"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary hypertension (PH) is a life\u2010threatening. Differentiation pulmonary arterial hypertension (PAH) from pulmonary venous hypertension (PVH) is important due to distinct treatment protocols. Invasive right heart catheterization (RHC) remains the reference standard but noninvasive alternatives are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose\/Hypothesis<\/jats:title><jats:p>To evaluate 4D Flow MRI\u2010derived 3D vortex energetics in the left pulmonary artery (LPA) for distinguishing PAH from PVH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective case\u2013control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population\/Subjects<\/jats:title><jats:p>Fourteen PAH patients (11 female) and 18 PVH patients (9 female) diagnosed from RHC, 23 healthy controls (9 female).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5\u2009T; gradient recalled echo 4D flow and balanced steady\u2010state free precession (bSSFP) cardiac cine sequences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>LPA 3D vortex cores were identified using the lambda2 method. Peak vortex\u2010contained kinetic energy (vortex\u2010KE) and viscous energy loss (vortex\u2010EL) were computed from 4D flow MRI. Left and right ventricular (LV, RV) stroke volume (LVSV, RVSV) and ejection fraction (LVEF, RVEF) were computed from bSSFP. In PH patients, mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWR) and pulmonary vascular resistance (PVR) were determined from RHC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Mann\u2013Whitney <jats:italic>U<\/jats:italic> test for group comparisons, Spearman's rho for correlations, logistic regression for identifying predictors of PAH vs. PVH and develop models, area under the receiver operating characteristic curve (AUC) for model performance. Significance was set at <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PAH patients showed significantly lower vortex\u2010KE (37.14 [14.68\u201378.52] vs. 76.48 [51.07\u2013120.51]) and vortex\u2010EL (9.93 [5.69\u201325.70] vs. 24.22 [12.20\u201332.01]) than PVH patients. The combined vortex\u2010KE and LVEF model achieved an AUC of 0.89 for differentiating PAH from PVH. Vortex\u2010EL showed significant negative correlations with mPAP (rho\u2009=\u2009\u22120.43), PCWP (rho\u2009=\u20090.37), PVR (rho\u2009=\u2009\u22120.64). In the PAH group, PVR was significantly negatively correlated with LPA vortex\u2010KE (rho\u2009=\u2009\u22120.73) and vortex\u2010EL (rho\u2009=\u2009\u22120.71), and vortex\u2010KE significantly correlated with RVEF (rho\u2009=\u20090.69), RVSV, (rho\u2009=\u20090.70). In the PVH group, vortex\u2010KE (rho\u2009=\u20090.52), vortex\u2010EL significantly correlated with RVSV (rho\u2009=\u20090.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>These preliminary findings suggest that 4D flow MRI\u2010derived LPA vortex energetics have potential to noninvasively differentiate PAH from PVH and correlate with invasive hemodynamic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>1<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 3<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29635","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T19:53:20Z","timestamp":1730145200000},"page":"2130-2143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["<scp>3D<\/scp> Vortex\u2010Energetics in the Left Pulmonary Artery for Differentiating Pulmonary Arterial Hypertension and Pulmonary Venous Hypertension Groups Using <scp>4D<\/scp> Flow <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-5668","authenticated-orcid":false,"given":"Mohammed S.M.","family":"Elbaz","sequence":"first","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melika","family":"Shafeghat","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin H.","family":"Freed","sequence":"additional","affiliation":[{"name":"Cardiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Sarnari","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2769-0772","authenticated-orcid":false,"given":"Zachary","family":"Zilber","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Avery","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Markl","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0667-137X","authenticated-orcid":false,"given":"Bradley D.","family":"Allen","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Carr","sequence":"additional","affiliation":[{"name":"Radiology Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02148-2018"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"issue":"2","key":"e_1_2_9_4_1","first-page":"173","article-title":"4D flow imaging with MRI","volume":"4","author":"Stankovic Z","year":"2014","journal-title":"Cardiovasc Diagn Ther"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14140849"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.25326"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27967"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25251"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.108.780247"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07287-6"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007010"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.10171"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21764"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1953.5.10.635"},{"key":"e_1_2_9_15_1","unstructured":"BockJ KreherB HennigJ MarklM editors.Optimized pre\u2010processing of time\u2010resolved 2D and 3D phase contrast MRI data. 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