Cardiovascular Surgery, University Hospital Bern, Switzerland.
Eur J Radiol. 2012 Apr;81(4):e502-6. doi: 10.1016/j.ejrad.2011.06.010. Epub 2011 Jun 23.
Comparison of arterial and venous coronary artery bypass flow measurements using 3-T magnetic resonance (MR) phase contrast in correlation with intraoperative Doppler flow measurements.
Fifty-six coronary bypasses (right coronary artery n=18, left internal mammary artery to left anterior descending artery n=16, marginal artery n=7, circumflex artery n=7, diagonal artery n=6, left anterior descending artery n=1, and right internal mammary artery to right coronary artery n=1) were studied in 27 asymptomatic patients. In this prospective study, each bypass was studied intra-operatively using Doppler flow measurement. Within one week post surgery, patients were studied using a 3-T MR scanner (Magnetom Verio, Siemens, Erlangen, Germany) using velocity encoded phase-contrast flow measurements.
Intraoperative Doppler flow measurements demonstrated regular flow patterns in all vascular territories supplied. All bypasses were patent on MRI and flow measurement results were as follows: median flow 60ml/min (interquartile range (IQR): 37.5-78.5ml/min). For comparison, the corresponding median intraoperative flow was 58ml/min (IQR: 41-80ml/min) (p<0.001; R=0.44). Linear regression analysis demonstrated a significant correlation for venous bypasses (p=0.0002; R=0.48), but not for arterial bypasses (p=0.09; R=0.24).
This study demonstrated that MR flow measurements of venous bypass grafts agreed more with Doppler than arterial bypass grafts. However, bypass patency was confirmed for all patients. In the future, this technique may be used for non invasive coronary bypass graft follow-up.
通过 3-T 磁共振(MR)相位对比测量与术中多普勒流量测量相关的动脉和静脉冠状动脉旁路流量,比较两者。
对 27 例无症状患者的 56 个冠状动脉旁路(右冠状动脉 n=18,左内乳动脉至左前降支 n=16,边缘动脉 n=7,回旋支 n=7,对角支 n=6,左前降支 n=1,右内乳动脉至右冠状动脉 n=1)进行了研究。在这项前瞻性研究中,每个旁路都在术中使用多普勒流量测量进行研究。手术后一周内,患者使用 3-T MR 扫描仪(Siemens,Erlangen,德国 Magnetom Verio)进行研究,使用速度编码相位对比流量测量。
术中多普勒流量测量显示所有受血管支配的区域均存在规则的血流模式。所有旁路在 MRI 上均显示通畅,流量测量结果如下:中位数流量 60ml/min(四分位距(IQR):37.5-78.5ml/min)。相比之下,相应的术中中位数流量为 58ml/min(IQR:41-80ml/min)(p<0.001;R=0.44)。线性回归分析显示,静脉旁路有显著相关性(p=0.0002;R=0.48),但动脉旁路无显著相关性(p=0.09;R=0.24)。
本研究表明,MR 流量测量对静脉旁路吻合的吻合与多普勒吻合更吻合,但所有患者的旁路均通畅。在未来,该技术可用于非侵入性冠状动脉旁路移植术后随访。