O'Brien Kieran R, Cowan Brett R, Jain Manali, Stewart Ralph A H, Kerr Andrew J, Young Alistair A
Bioengineering Institute, University of Auckland, Auckland, New Zealand.
J Magn Reson Imaging. 2008 Jul;28(1):210-8. doi: 10.1002/jmri.21395.
To clarify the use of MRI phase contrast (PC), as an alternative to Doppler echocardiography, when measuring high-velocity turbulent jets associated with stenotic valvular disease.
In vivo PC aortic stroke volume (SV) was compared with ventricular SV in 31 patients with moderate to severe aortic stenosis (AS). Two in vitro pipe experiments were conducted to evaluate errors in steady stenotic and nonstenotic turbulent flows.
The average in vivo error in SV was -24% in the left-ventricular (LV) outflow tract (LVOT) and -41% in the aortic root. Errors were most prominent in patients with the highest Doppler peak velocities. In vitro nonstenotic flow experiments showed accurate flow measurement with an average error of 1.8%. Significant errors were found in the in vitro stenotic flow, which reduced with shorter echo times (TE): average error -166/-67/-25/-13/-8.8% for TEs of 4.8/4.0/3.3/2.2/2.0 msec. In both the in vivo and in vitro stenotic experiments the errors were associated with signal loss in the flow-compensated magnitude image.
Signal loss is associated with flow errors in stenotic jets. Current clinically available PC pulse sequences with TE >2 msec may not accurately quantify flow for severe lesions.
阐明在测量与狭窄瓣膜疾病相关的高速湍流时,使用磁共振成像相位对比(PC)技术替代多普勒超声心动图的情况。
对31例中重度主动脉瓣狭窄(AS)患者,比较其体内PC主动脉搏出量(SV)与心室SV。进行了两项体外管道实验,以评估稳定狭窄和非狭窄湍流中的误差。
左心室(LV)流出道(LVOT)的体内SV平均误差为-24%,主动脉根部为-41%。在多普勒峰值速度最高的患者中,误差最为显著。体外非狭窄血流实验显示流量测量准确,平均误差为1.8%。体外狭窄血流实验发现显著误差,随着回波时间(TE)缩短误差减小:TE为4.8/4.0/3.3/2.2/2.0毫秒时,平均误差分别为-166/-67/-25/-13/-8.8%。在体内和体外狭窄实验中,误差均与血流补偿幅度图像中的信号丢失有关。
信号丢失与狭窄射流中的血流误差有关。目前临床可用的TE>2毫秒的PC脉冲序列可能无法准确量化严重病变的血流。