{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:26:31Z","timestamp":1787214391372,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/20\/10008"],"award-info":[{"award-number":["PG\/20\/10008"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance in Med"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the impact of intra\/extracellular water exchange (WX) on quantitative dynamic contrast\u2010enhanced (DCE) MRI in patients with severe aortic stenosis (AS). The aims were to compare low\u2010dose (WX insensitive) and high\u2010dose (WX sensitive) DCE\u2010MRI measurements, and to compare data acquired before and after aortic valve replacement (AVR) to test whether DCE\u2010MRI was able to detect changes in myocardial extracellular volume fraction (ECV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010five patients with severe AS were studied at 3\u2009T before and 6\u2009months after AVR. DCE\u2010MRI was performed at rest twice using a low contrast agent dose (0.05\u2009mmol\/kg gadobutrol) followed by a high\u2010dose (0.1\u2009mmol\/kg gadobutrol). Estimates of myocardial blood flow (MBF) and ECV were obtained using models which assume instantaneous WX (fast exchange [FX]) and which incorporate WX (a two\u2010site exchange [2SX] model). ECV estimates were also made using T1 maps acquired before and after contrast administration, both assuming FX and incorporating WX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FX model estimates of MBF and ECV obtained before AVR decreased from low\u2010 to high\u2010dose contrast consistent with the effect of limited WX. This decrease was partially corrected using a 2SX model. However, 2SX model fits were preferred over FX fits in only 2 of 24 high\u2010dose data sets (\n                      <jats:italic>F<\/jats:italic>\n                      \u2010test). ECV estimates made using DCE\u2010MRI increased after AVR consistent with changes seen using T1 maps, but the ECV estimates were lower.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Estimates of MBF using DCE\u2010MRI showed negligible sensitivity to WX. DCE\u2010MRI\u2010based ECV estimates changed post\u2010AVR but were systematically lower than those made using T1 maps.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mrm.70571","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:20:56Z","timestamp":1787214056000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Water Exchange on Estimates of Myocardial Blood Flow and Extracellular Volume Fraction Using Dynamic Contrast\u2010Enhanced\n                    <scp>MRI<\/scp>\n                    in Patients Treated for Severe Aortic Stenosis"],"prefix":"10.1002","author":[{"given":"Alex","family":"Makins","sequence":"first","affiliation":[{"name":"Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"},{"name":"Department of Medical Physics &amp; Engineering Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Biglands","sequence":"additional","affiliation":[{"name":"Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"},{"name":"Department of Medical Physics &amp; Engineering Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Sharrack","sequence":"additional","affiliation":[{"name":"Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kellman","sequence":"additional","affiliation":[{"name":"National Heart, Lung, and Blood Institute National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Plein","sequence":"additional","affiliation":[{"name":"Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6659-8365","authenticated-orcid":false,"given":"David L.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"2","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/(SICI)1522-2594(199902)41:2<334::AID-MRM18>3.0.CO;2-Y","article-title":"Effects of Water Exchange on the Measurement of Myocardial Perfusion Using Paramagnetic Contrast Agents","volume":"41","author":"Judd R. 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Cardiovascular Imaging"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1002\/mrm.29956","article-title":"The Impact of Water Exchange on Estimates of Myocardial Extracellular Volume Calculated Using Contrast Enhanced T1 Measurements: A Preliminary Analysis in Patients With Severe Aortic Stenosis","volume":"91","author":"Sharrack N.","year":"2024","journal-title":"Magnetic Resonance in Medicine"},{"issue":"11","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1161\/CIRCULATIONAHA.112.000438","article-title":"Quantification of Cardiomyocyte Hypertrophy by Cardiac Magnetic Resonance: Implications for Early Cardiac Remodeling","volume":"128","author":"Coelho\u2010Filho O. 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S.","year":"2000","journal-title":"Magnetic Resonance in Medicine"},{"issue":"2","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/mrm.1910230205","article-title":"Quantification of Myocardial Blood Flow and Extracellular Volumes Using a Bolus Injection of Gd\u2010DTPA: Kinetic Modeling in Canine Ischemic Disease","volume":"23","author":"Diesbourg L. D.","year":"1992","journal-title":"Magnetic Resonance in Medicine"},{"issue":"3","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1002\/mrm.22861","article-title":"On the Scope and Interpretation of the Tofts Models for DCE\u2010MRI","volume":"66","author":"Sourbron S. 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L.","year":"2008","journal-title":"Magnetic Resonance in Medicine"},{"issue":"2","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/mrm.27456","article-title":"Shutter\u2010Speed Dynamic Contrast\u2010Enhanced MRI: Is It Fit for Purpose?","volume":"81","author":"Buckley D. L.","year":"2019","journal-title":"Magnetic Resonance in Medicine"},{"issue":"8","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jacc.2017.12.035","article-title":"Reverse Myocardial Remodeling Following Valve Replacement in Patients With Aortic Stenosis","volume":"71","author":"Treibel T. 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