Turk A S, Johnson K M, Lum D, Niemann D, Aagaard-Kienitz B, Consigny D, Grinde J, Turski P, Haughton V, Mistretta C
Department of Radiology, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
AJNR Am J Neuroradiol. 2007 Jan;28(1):111-5.
Noninvasive assessment of the hemodynamic significance of carotid stenosis is often performed with MR angiography and supplemented with carotid Doppler sonography. Phase contrast with vastly undersampled isotropic projection reconstruction (PC-VIPR), a novel MR imaging technique, accelerates phase-contrast MR flow imaging and provides both images of the vessels and measurements of blood-flow velocities. For this study, we determined the accuracy of PC-VIPR blood-flow velocity measurements to determine pressure gradients across an experimental carotid stenosis.
A focal stenosis was surgically created in each common carotid artery of 6 canines. Digital subtraction angiography (DSA) was performed, and the degree of stenosis was determined using the North American Symptomatic Carotid Endarterectomy Trial methodology. A microcatheter was positioned in the carotid artery proximal and distal to the stenosis, and pressures were measured in the vessel through the catheter. PC-VIPR was then performed on a 1.5T MR imaging scanner with parameters producing 0.8-mm isotropic voxel resolution. From the velocity measurements, pressure gradients were calculated from the Navier-Stokes relationship to compare with the pressures measured by a catheter.
Carotid stenoses in the 50%-85% range were produced in the 12 arteries. Pressure gradients across the stenoses ranged from 6 to 26 mm Hg. The pressure gradient calculated from the PC-VIPR data correlated (r = 0.91, P < .0001) with the actual pressure measurements.
With PC-VIPR, a novel MR imaging technique, the hemodynamic effect of a stenosis on flow and pressure can be evaluated.
对颈动脉狭窄血流动力学意义的无创评估通常采用磁共振血管造影,并辅以颈动脉多普勒超声检查。相位对比与大幅欠采样各向同性投影重建(PC-VIPR)是一种新型磁共振成像技术,可加速相位对比磁共振血流成像,并提供血管图像和血流速度测量值。在本研究中,我们确定了PC-VIPR血流速度测量的准确性,以确定实验性颈动脉狭窄两端的压力梯度。
在6只犬的每条颈总动脉上手术制造一个局灶性狭窄。进行数字减影血管造影(DSA),并使用北美症状性颈动脉内膜切除术试验方法确定狭窄程度。将一根微导管置于狭窄近端和远端的颈动脉内,通过导管测量血管内压力。然后在一台1.5T磁共振成像扫描仪上进行PC-VIPR检查,参数设置产生0.8mm各向同性体素分辨率。根据速度测量值,利用纳维-斯托克斯关系计算压力梯度,以与导管测量的压力进行比较。
12条动脉产生了50%-85%范围的颈动脉狭窄。狭窄两端的压力梯度范围为6至26mmHg。根据PC-VIPR数据计算的压力梯度与实际压力测量值相关(r = 0.91,P <.0001)。
利用新型磁共振成像技术PC-VIPR,可以评估狭窄对血流和压力的血流动力学影响。