Matthias Grothoff

• HHL Leipzig Graduate School of Management

Background The rotational direction (RD) of helical blood flow can be classified as either a clockwise (RD⁺) or counter-clockwise (RD⁻) flow. We hypothesized that this simple classification might not be sufficient for analysis in vivo and a simultaneous existence of RD+/− may occur. We utilized volumetric velocity-sensitive cardiovascular magnetic...

Purpose To utilize 4 D flow MRI to acquire normal values of “conventional 2 D flow MRI parameters” in healthy volunteers in order to replace multiple single 2 D flow measurements with a single 4 D flow acquisition. Materials and Methods A kt-GRAPPA accelerated 4 D flow sequence was used. Flow volumes were assessed by forward (FFV), backward (BFV),...

Objectives 4D flow MRI enables quantitative assessment of helical flow. We sought to generate normal values and elucidate changes of helical flow (duration, volume, length, velocities and rotational direction) and flow jet (displacement, flow angle) as well as wall shear stress (WSS). Methods We assessed the temporal helical existence ( TH EX ), m...

AIM To investigate the observer agreement for the assessment of chronic myocarditis by native T1 and T2 relaxation times, post-contrast T1 relaxation time, and extracellular volume (ECV) fraction, compared to Lake Louise Criteria: oedema ratio (OR) and early gadolinium enhancement ratio (EGEr). MATERIALS AND METHODS Data were collected retrospecti...

Background Pathophysiological differences in relief of pulmonary stenosis (PS) as opposed to pulmonary regurgitation (PR) by percutaneous pulmonary valve implantation (PPVI) remain elusive, but might impact current assessment of procedural success and ultimately indications. Methods Invasive pressure measurements, cardiac magnetic resonance imaging...

4D flow MRI enables quantitative assessment of helical flow. Current methods are susceptible to noise. To evaluate helical flow patterns in healthy volunteers and patients with bicuspid aortic valves (BAV) at 1.5 T and 3 T using pressure-based helix-extraction in 4D flow MRI. Two intraindividual 4D flow MRI examinations were performed at 1.5 T and...

Background Four-dimensional (4D) flow magnetic resonance imaging (MRI) sequences with advanced parallel imaging have the potential to reduce scan time with equivalent image quality and accuracy compared with standard two-dimensional (2D) flow MRI. We compared 4D flow to standard 2D flow sequences using a constant and pulsatile flow phantom at 3 T....

To compare contrast-enhanced magnetic resonance angiography (ceMRA) and 3D steady-state free precession (SSFP) during systole and diastole for assessment of the right ventricle outflow tract (RVOT) in patients considered for percutaneous pulmonary valve implantation (PPVI) after tetralogy of Fallot (TOF) repair. We retrospectively evaluated 89 pati...

To compare two broadly used 4D-flow- with a 2D-flow-sequence in healthy volunteers, regarding absolute flow parameters, image quality (IQ), and eddy current correction (ECC). Forty volunteers (42 ± 11.8 years, 22 females) were examined with a 3T scanner. Thoracic aortic flow was assessed using a 3D-T2w-SPACE-STIR-sequence for morphology and two acc...

Background Prenatal risk stratification of women with previous cesarean section (CS) by ultrasound thickness measurement of the lower uterine segment (LUS) is challenging. There is a wide range of proposed cutoff values and a valuable algorithm for selection before birth is not available. Using 3 T magnetic resonance imaging (MRI), we aimed to iden...

4D PC-MRI enables the assessment of blood flow velocity vectors of one heart beat. These time-dependent, three-dimensional data allow for a comprehensive analysis and contain plenty of information. So far, 4D PC-MRI is used for research purposes. One reason is a lack of standardized, easy-to-use evaluation software, which is crucial for potential a...

Objectives To assess the incidence of acute adverse events (AAEs) in gadolinium-enhanced cardiac magnetic resonance (CMR) imaging. Methods Gadolinium-based contrast agent (GBCA)–enhanced CMR data from the multinational, multicenter European Society of Cardiovascular Radiology MRCT Registry was included. AAE severity was classified according to the...

Purpose Uterine rupture during labor is a rare but life-threatening complication after previous cesarean section (CS). Prenatal risk is assessed using ultrasound thickness measurement of the lower uterine segment (LUS). Due to inhomogeneous study results, however, clinical obstetrics still lacks for standard protocols and reliable reference values....

Transposition of the great arteries (TGA) is the second most common cyanotic congenital heart disease. It is characterized by a ventriculo-arterial discordance with the aorta arising from the right ventricle and the pulmonary artery arising from the left ventricle. For initial diagnosis echocardiography is used. The postoperative imaging protocol s...

Flow in the great arteries (aorta, pulmonary artery) is normally laminar with a parabolic velocity profile. Eccentric flow jets are linked to various diseases like aneurysms. Cardiac 4D PC‐MRI data provide spatio‐temporally resolved blood flow information for the whole cardiac cycle. In this work, we establish a time‐dependent visualization and qua...

We propose a technique for vortex extraction in cardiac 4D PC-MRI blood flow data that employs an intravascular, relative pressure calculation. The method is easy to implement, runs fully automatically, and requires no user-defined parameters. We qualitatively evaluated 100+ datasets of the aorta, pulmonary artery, or left ventricle from healthy vo...

One of the main concerns in planning a vaginal birth after previous cesarean section is the risk for uterine rupture which is considered to be associated with the wall thickness in the scar area. Assuming the uterine scar to be located within the lower uterine segment (LUS), ultrasound diagnostic with LUS thickness measurement is widely used for pr...

Purpose: Dilatation of the thoracic aorta is a well-known finding in corrected Tetralogy of Fallot. Complications are rare but can be life-threatening. Standard 1-dimensional (1D) measurements have several limitations. We sought to establish contrast-enhanced magnetic resonance angiography cross-sectional areas of the aorta that could serve as ref...

Objective To compare cardiac left ventricular (LV) parameters in simultaneously acquired hybrid fluorine-18-fluorodeoxyglucose ([18F] FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with residual tracer activity of upstream PET/CT. Methods Twenty-nine patients (23 men, age 58±17 years) underwent cardiac PET/MRI e...

Aims: To assess silent and clinically apparent cerebral embolic events in patients undergoing transcatheter left atrial appendage closure. Methods and results: In this prospective single-center study 28 patients underwent percutaneous closure of the left atrial appendage. In all patients a diffusion-weighted magnetic resonance imaging (DWI-MRI)...

Background: Even if lower vaginal delivery success rates and impaired neonatal short-term outcomes have been reported for primiparous women with breech presentation, vaginal breech delivery remains an option for carefully selected patients. Because Magnetic resonance imaging (MRI) pelvimetry can provide additional information on maternal pelvic mo...

Objectives To evaluate the feasibility of performing comprehensive Cardiac Magnetic resonance (CMR) guided electrophysiological (EP) interventions in a porcine model encompassing left atrial access. Methods After introduction of two femoral sheaths 14 swine (41 ± 3.6 kg) were transferred to a 1.5 T MR scanner. A three-dimensional whole-heart sequen...

Background: Data suggest that T1 and T2 mapping have excellent diagnostic accuracy in patients with suspected myocarditis. However, the true diagnostic performance of comprehensive cardiac magnetic resonance (CMR) mapping versus endomyocardial biopsy (EMB) has not been determined. Objectives: This study assessed the performance of CMR imaging, i...

Four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) acquisitions facilitate the assessment of time-resolved, 3D blood flow information. Vortex flow in the aorta or pulmonary artery is of special clinical interest, since it can be an indicator for different pathologies of the cardiovascular system. Qualitative methods commonly emp...

Dilatation of the ascending aorta is a common finding in Tetralogy of fallot (TOF). We sought to provide aortic dimensions in children and adolescents after corrected TOF obtained by contrast-enhanced cardiac-magnetic-resonance angiography (CE-CMRA) that could serve as reference values. We enrolled 101 children and adolescents (56 male) with a medi...

Recently cardiac magnetic resonance (CMR) imaging has been found feasible for the visualization of the underlying substrate for cardiac arrhythmias as well as for the visualization of cardiac catheters for diagnostic and ablation procedures. Real-time CMR-guided cavotricuspid isthmus ablation was performed in a series of six patients using a combin...

4D PC-MRI enables the noninvasive measurement of time-resolved, three-dimensional blood flow data that allow quantification of the hemodynamics. Stroke volumes are essential to assess the cardiac function and evolution of different cardiovascular diseases. The calculation depends on the wall position and vessel orientation, which both change during...

Background: In the autonomic nerve system most sympathetic neurons synapse peripherally in the ganglia of the sympathetic trunk. A reduction in sympathicotonia by partial elimination of these ganglia is a therapeutic approach that has been used for more than 100 years. In the early 1920s the first attempts at percutaneous sympathicolysis (SL) were...

Four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) allows the non-invasive acquisition of time-resolved, 3D blood flow information. Stroke volumes (SVs) and regurgitation fractions (RFs) are two of the main measures to assess the cardiac function and severity of valvular pathologies. The flow rates in forward and backward direct...

To compare the performance of semi-automatic versus manual segmentation for ECG-triggered cardiovascular computed tomography (CT) examinations prior to transcatheter aortic valve replacement (TAVR), with focus on the speed and precision of experienced versus inexperienced observers. The preoperative ECG-triggered CT data of 30 consecutive patients...

Background Bicuspid aortic valves (BAV) are associated with aneurysms of the ascending aorta (AAA). It is unclear whether these aneurysms are caused by tissue alterations of the aortic wall or by alterations of blood flow in the ascending aorta due to the bicuspid valve morphology. In this study we analyzed the phase contrast 4D flow characteristic...

Radiofrequency (RF) ablation with irrigated tip catheters decreases the likelihood of thrombus and char formation and enables the creation of larger lesions. Due to the potential dramatic consequences, the prevention of thromboembolic events is of particular importance for left-sided procedures. Although acute success rates of ventricular tachycard...

a) Graph cut-assisted vessel segmentation. (b) Semi-automatic vortex extraction. (c) Cardiac function assessment. Figure 1: Screenshots of the presented software Bloodline for cardiac 4D PC-MRI data evaluation. Abstract Four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) allows the non-invasive acquisition of temporally resolved,...

Objective: To test the hypothesis that myocardial scars after repair of tetralogy of Fallot are related to impaired cardiac function and adverse clinical outcome. Methods: A total of 53 patients were retrospectively analysed after repair of tetralogy of Fallot. The median patient age was 20 years (range 2-48). Cardiac MRI with a 1.5 T magnet inc...

For a long time the right ventricle was hardly noticed in the pathophysiology of cardiovascular diseases. The advancement in echocardiography and the increasing availability of magnetic resonance imaging (MRI) amended the understanding of the RV and led to a decisive improvement of diagnosis and treatment of cardiovascular diseases such as congenit...

Background: The aim of this study was to analyze the angle between the left ventricular (LV) long axis and the LV outflow tract (αLV-LVOT) on cardiac computed tomography and to describe its effect on the occurrence of paravalvular leakage (PL), fluoroscopy time, and postoperative creatine kinase-MB levels in transapical transcatheter aortic valve...

In computed tomography (CT) evaluation prior to transcatheter aortic valve implantation area- and perimeter-based calculation of the aortic annulus diameter, the so-called effective annulus diameter (ED), is the preferred parameter for decision making regarding prosthesis sizes. Currently, it is unclear how relevant the differences between the two...

Purpose: To compare the performance of server-based (CSS) versus stand-alone post-processing software (ES) for the evaluation of cardiovascular CT examinations (cvCT) and to determine the crucial steps. Materials and methods: Data of 40 patients (20 patients for coronary artery evaluation and 20 patients prior to transcatheter aortic valve impla...

Background: Intramyocardial haemorrhage (IMH) and microvascular obstruction (MVO) represent reperfusion injury after reperfused ST-elevation myocardial infarction (STEMI) with prognostic impact and "hypointense core" (HIC) appearance in T2-weighted images. We aimed to distinguish between IMH and MVO by using T2 (*)-weighted cardiovascular magnetic...

Real-time magnetic resonance imaging (MRI) combines the advantages of excellent soft-tissue characterization in a true 3D anatomical and functional model with the possibility of lesion and gap visualization without the need of any radiation. Therefore, real-time MRI presents a particularly attractive imaging technology to guide electrophysiology st...

Objective Comparing the diagnostic value of multi-sequential cardiac magnetic resonance imaging (CMR) with endomyocardial biopsy (EMB) for sub-clinical cardiac allograft rejection. Methods One hundred and forty-six examinations in 73 patients (mean age 53 ± 12 years, 58 men) were performed using a 1.5 Tesla system and compared to EMB. Examinations...

Purpose: To assess if real-time magnetic resonance (MR) imaging-guided radiofrequency (RF) ablation for atrial flutter is feasible in patients. Materials and methods: The study complied with the Declaration of Helsinki and was approved by the local ethics committee. All patients were informed about the investigational nature of the procedures an...

Background The aim of this study was to test the interobserver variability of myocardial T1 and T2 Mapping prior to and T1 Mapping after the administration of contrast agent in patients with suspected myocarditis. The established methods for the detection of the presence of active inflammation - edema ratio (ER) and global relative enhancement (gRE...

The presence of pericardial effusion (PE) is considered to be suggestive of inflammation in suspected myocarditis. However, the incremental value of assessing for PE in addition to comprehensive cardiac magnetic resonance (CMR) imaging remains unclear. In total, 132 patients with suspected acute (AMC) or chronic myocarditis (CMC) were included. All...

Percutaneous transcatheter aortic valve implantation (TAVI) is an established alternative to open heart surgery in patients with severe aortic stenosis (AS) unsuitable for conventional aortic valve replacement due to comorbidities with a high perioperative risk or contraindications. Preprocedural imaging plays a major role for adequate determinatio...

Der perkutane, kathetergestützte Aortenklappenersatz („transcatheter aortic valve implantation“, TAVI) ist eine etablierte Alternative für Patienten mit schwerer Aortenklappenstenose (AS), wenn sie wegen Komorbiditäten und damit verbundenem hohem perioperativem Risiko oder Kontraindikationen für einen konventionellen, offen-chirurgischen Aortenklap...

Unlabelled: Transcatheter aortic valve implantation (TAVI) is currently considered an acceptable alternative for the treatment of patients with severe aortic stenosis and a high perioperative risk or a contraindication for open surgery. The benefit of TAVI significantly outweighs the risk of the procedure in patients requiring treatment that are n...

Purpose: To determine the time course of enhancement patterns in the aorta and endoleaks at dynamic computed tomographic (CT) angiography as well as their effect on the endoleak detection rate in patients who have undergone abdominal aortic endovascular aneurysm repair (EVAR). Materials and methods: This retrospective study was approved by the l...

Objectives: To test the hypothesis that myocardial scars cause systolic dysfunction in patients with transposition of the great arteries and a systemic right ventricle. Methods: We retrospectively analyzed 20 consecutive patients (10 male, mean age 27.3 years) with a systemic right ventricle who underwent cardiac magnetic resonance imaging with...

Magnetic resonance imaging (MRI) has evolved as a standard cardiac imaging technique. Interventional procedures guided by real-time MRI may derive potential benefit from a fluoroscopy-free working environment, more detailed insights into the target anatomy, and additional information on organ tissue properties relevant for pathomorphology as well a...

Background Two-dimensional (2D) phase contrast (PC) magnetic resonance imaging (MRI) enables non-invasive measurements of forward and backward flow, shunt volumina and peak velocity. It is an important tool in the diagnosis and follow-up of patients with congenital or acquired cardiovascular diseases. However, planning and repeated acquisition of m...

PURPOSE Atrio-esophageal fistulas represent a rare but potentially lethal complication of catheter ablation of atrial fibrillation (AF). The topographic relationship of the esophagus (ESO) behind the left atrium (LA), especially in relation to the spine and descending aorta may predict the occurrence of esophageal damage. METHOD AND MATERIALS A to...

To evaluate the inter-individual variance and the variability of the aortic root dimensions during the cardiac cycle by computed tomography (CT) in patients with severe aortic stenosis prior to transcatheter aortic valve implantation (TAVI). Fifty-six patients (m/w = 16/40, 81 ± 6.8 years), scheduled for a transapical aortic valve implantation with...

AimsMagnetic resonance imaging (MRI) in the context of electrophysiology (EP) studies facilitates visualization of complex three-dimensional anatomy and the underlying arrhythmogenic substrate, real-time passive visualization of catheters, atrial and ventricular function and complications, as well as lesion visualization during the ablation without...

Objectives To analyse the value of cardiovascular magnetic resonance (CMR)-derived myocardial parameters to differentiate left ventricular non-compaction cardiomyopathy (LVNC) from other cardiomyopathies and controls. Methods We retrospectively analysed 12 patients with LVNC, 11 with dilated and 10 with hypertrophic cardiomyopathy and compared them...

Background Systemic right ventricle (RV) hypertrophy and impaired function occur after atrial switch for dextro-transposition of the great arteries (d-TGA). Echocardiography is limited in its ability to assess the RV. We sought to evaluate systemic RV myocardial-mass index (MMI) and function after atrial switch and to analyse the role of hypertroph...

To evaluate for the first time the degree of compliance between conventional multislice computed tomography (MSCT) and three-dimensional rotational angiography (3D-RA) in measuring relevant dimensions of the aortic annulus, the aortic root and the thoracic aorta in patients undergoing TA-AVI. Twenty-seven patients (82 ± 11 years) with severe aortic...

BACKGROUND: Patients with a congenitally corrected transposition of the great arteries show an increasing incidence of cardiac failure with age. In other systemic right ventricles, such as in dextro-transposition after atrial switch, excessive hypertrophy is a potential risk factor for impaired systolic function. In this trial, we sought to compare...

The goal of this study was to assess the diagnostic performance of cardiac magnetic resonance (CMR) compared with endomyocardial biopsy in patients with suspected acute myocarditis (AMC) and chronic myocarditis (CMC). Several studies have reported an encouraging diagnostic performance of CMR in myocarditis. However, the comparison of CMR with clini...

Ziele: Die Magnetresonanztomographie (MRT) erlaubt bei elektrophysiologischen (EP) Interventionen die Darstellung des arrhythmogenen Substrates, die Echtzeitdarstellung der Herzfunktion sowie die Kontrolle der Ablationslasionen ohne Verwendung von ionisierenden Strahlen. Im Folgenden werden erste Erfahrungen mit Echtzeit MRT gestutzten EP Intervent...

To assess differences in aortic and endoleak enhancement in patients after endovascular aneurysm repair (EVAR) with dynamic computed tomography (CT) angiography. Twenty-one consecutive patients (mean age, 74.5 y ± 6; range, 61-88 y) with endoleaks after EVAR of the abdominal aorta were examined on a second-generation dual-source CT unit with 10 uni...

Both infarct size and microvascular obstruction (MO) assessed by cardiac magnetic resonance imaging (CMR) are known to be predictors for adverse clinical outcome after ST-elevation myocardial infarction (STEMI). We hypothesized that a ratio of MO and infarct size (MO/infarct size) might be an even stronger predictor for outcome after STEMI, which h...

PURPOSE Magnetic resonance imaging (MRI) guided electrophysiology (EP) studies facilitate visualization of three-dimensional anatomy with the respective underlying arrhythmia substrate, real-time visualization of functional informations and complications, as well as lesion visualization during ablation under elimination of radiation exposure. We pr...

Zielsetzung: Vergleich der Abstande der Koronarostien von den basalen Insertionsstellen der Aortenklappentaschen (AT) zur Lange der AT mittels Computertomografie (CT) vor transapikaler Aortenklappenimplantation (TAAVI) zur Beurteilung einer potentiellen intraproceduralen Obstruktion der Koronarostien durch die native AT. Material und Methoden: Es w...

Fragestellung: Die bestehenden Abweichungen zwischen den jahrlichen Expansionsraten von Aortensegmenten in der CT, die aus dem Gefassegmentvolumen, dem maximalen orthogonalen Durchmesser, der maximalen orthogonalen Querschnittsflache und der Gefassegmentausenoberflache berechnet wurden, sollen bestimmt werden. Material und Methoden: Es wurden 73 Pa...

Transposition of the great arteries (TGA) is a rare disease representing not more than 3–5% of all congenital heart diseases. TGA is a cardiac anomaly in which the aorta arises entirely or largely from the morphological right ventricle and the pulmonary artery from the morphological left ventricle. This is called a ventriculo-arterial discordant co...