Matre Knut, Ersland Lars, Larsen Terje H, Andersen Erling
Institute of Medicine, University of Bergen, Bergen, Norway.
Scand Cardiovasc J. 2002 May;36(3):180-6.
Differences of opinion in the literature about the agreement between magnetic resonance imaging (MRI) and ultrasound Doppler (USD) for high blood velocity measurement were the basis for this investigation. It compares in vitro velocity measurements by MRI with intraluminal USD, using a specially designed flow phantom.
The flow phantom consisted of a pulsatile pump, tubing, a prosthetic heart valve, measurement sections and a reservoir. Peak systolic velocities (0.7-5.0 m/s, n = 10) were measured with standard MRI phase shift velocity mapping using different regions of interest (ROIs). Intravascular USD velocity measurements were carried out using a thin cannula measuring peak systolic local maximum and local mean velocity within the small sample volume.
Using maximum velocity USD recordings, comparison with MRI velocities was poor when the ROI covered the complete vessel lumen giving offset -22.3% and limits of agreement (LOA) 57.5 and 105.1%. When the ROI was small the velocities were closer with offset -11.8% and LOA 75.3-103.3%. When the spatial resolution was comparable and the spatial mean was read from the USD recordings, the velocities showed good agreement with an offset close to zero (0.45%).
This study shows the importance of selecting small ROIs when using MRI for evaluating valve stenosis. Only when using spatially mean velocities over comparable regions the two methods showed good agreement.
文献中关于磁共振成像(MRI)和超声多普勒(USD)在高血流速度测量方面一致性的观点存在差异,本研究以此为基础。使用专门设计的血流模型,比较MRI体外速度测量与腔内USD测量结果。
血流模型由一个搏动泵、管道、一个人工心脏瓣膜、测量段和一个储液器组成。使用标准MRI相移速度映射,在不同感兴趣区域(ROI)测量收缩期峰值速度(0.7 - 5.0米/秒,n = 10)。使用细套管在小样本体积内测量血管内USD速度,测量收缩期峰值局部最大值和局部平均速度。
使用USD最大速度记录时,当ROI覆盖整个血管腔时,与MRI速度的比较较差,偏移为 - 22.3%,一致性界限(LOA)为57.5%和105.1%。当ROI较小时,速度更接近,偏移为 - 11.8%,LOA为75.3 - 103.3%。当空间分辨率可比且从USD记录中读取空间平均值时,速度显示出良好的一致性,偏移接近零(0.45%)。
本研究表明,使用MRI评估瓣膜狭窄时选择小ROI的重要性。只有在可比区域使用空间平均速度时,两种方法才显示出良好的一致性。