使用相位对比（PC）磁共振成像无创测量冠状动脉狭窄两端的压力梯度：一项可行性研究。
Noninvasive measurement of pressure gradient across a coronary stenosis using phase contrast (PC)-MRI: A feasibility study.
作者信息
Deng Zixin, Fan Zhaoyang, Lee Sang-Eun, Nguyen Christopher, Xie Yibin, Pang Jianing, Bi Xiaoming, Yang Qi, Choi Byoung-Wook, Kim Jung-Sun, Berman Daniel, Chang Hyuk-Jae, Li Debiao
机构信息
Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Department of Bioengineering, University of California, Los Angeles, California, USA.
出版信息
Magn Reson Med. 2017 Feb;77(2):529-537. doi: 10.1002/mrm.26579. Epub 2016 Dec 26.
PURPOSE
To investigate the feasibility of blood pressure difference measurement, ΔP, across the coronary artery using phase contrast (PC)-MRI for potential noninvasive assessment of the functional significance of coronary artery stenosis.
METHODS
Three-directional velocities in the coronary arteries acquired using 2D-PC-MRI were used with the Navier-Stokes equations to derive ΔP. Repeat phantom studies were performed to assess the reproducibility of flow velocity and ΔP. ΔP derived using PC-MRI (ΔP ) and that obtained using pressure transducer (ΔP ) were compared. Reproducibility of coronary flow velocity was assessed in healthy controls (n = 11). Patients with suspected coronary artery disease (n = 6) were studied to evaluate the feasibility of ΔP measurement across a coronary stenosis.
RESULTS
Phantom: Good overall reproducibility of flow velocity and ΔP measurements and excellent correlation (ΔP vs ΔP ) was observed: intraclass correlation (ICC) of 0.95(V ), 0.72(V ), 0.73(V ), and 0.87(ΔP ) and R = 0.94, respectively. Human: Good reproducibility of coronary flow velocity was observed: ICC of 0.94/0.95(V ), 0.76/0.74(V ), and 0.80/0.77(V ) at cardiac phase 1/2. Significant (p = 0.025) increase in ΔP was observed in patients (6.40 ± 4.43 mmHg) versus controls (0.70 ± 0.57 mmHg).
CONCLUSION
ΔP in the coronary arteries is feasible. Upon further validation using the invasive measure, ΔP has the potential for noninvasive assessment of coronary artery stenosis. Magn Reson Med 77:529-537, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
目的
探讨使用相位对比（PC）-MRI测量冠状动脉两端血压差（ΔP）以对冠状动脉狭窄功能意义进行潜在无创评估的可行性。
方法
利用二维PC-MRI获取冠状动脉内的三维速度，并结合纳维-斯托克斯方程推导ΔP。进行重复的模型研究以评估流速和ΔP的可重复性。比较使用PC-MRI得出的ΔP（ΔP ）与使用压力传感器获得的ΔP 。在健康对照者（n = 11）中评估冠状动脉流速的可重复性。对疑似冠心病患者（n = 6）进行研究，以评估测量冠状动脉狭窄两端ΔP的可行性。
结果
模型：流速和ΔP测量的总体可重复性良好，且观察到二者具有极佳的相关性（ΔP 与ΔP ）：组内相关系数（ICC）分别为0.95（V ）、0.72（V ）、0.73（V ）和0.87（ΔP ），R = 0.94。人体：观察到冠状动脉流速具有良好的可重复性：在心动周期第1/2期时，ICC分别为0.94/0.95（V ）、0.76/0.74（V ）和0.80/0.77（V ）。与对照组（0.70±0.57 mmHg）相比，患者组（6.40±4.43 mmHg）的ΔP显著升高（p = 0.025）。
结论
冠状动脉ΔP测量是可行的。在使用侵入性测量方法进一步验证后，ΔP有潜力用于冠状动脉狭窄的无创评估。《磁共振医学》77:529 - 537, 2017。© 2016国际磁共振医学学会。
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