Noninvasive measurement of pressure gradient across a coronary stenosis using phase contrast (PC)-MRI: A feasibility study

作者：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

来源：Magnetic Resonance in Medicine, 2017, 77(2): 529-537.

DOI：10.1002/mrm.26579

• fractional flow reserve (FFR)
• magnetic resonance imaging (MRI)
• phase-contrast MRI (PC-MRI)
• relative pressure difference estimation
• coronary artery disease (CAD)
• coronary pressure gradient

PurposeTo investigate the feasibility of blood pressure difference measurement, P, across the coronary artery using phase contrast (PC)-MRI for potential noninvasive assessment of the functional significance of coronary artery stenosis.
MethodsThree-directional velocities in the coronary arteries acquired using 2D-PC-MRI were used with the Navier-Stokes equations to derive P. Repeat phantom studies were performed to assess the reproducibility of flow velocity and P. P derived using PC-MRI (P-MR) and that obtained using pressure transducer (P-PT) 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 P-MR measurement across a coronary stenosis.
ResultsPhantom: Good overall reproducibility of flow velocity and P measurements and excellent correlation (P-MR vs P-PT) was observed: intraclass correlation (ICC) of 0.95(V-z), 0.72(V-x), 0.73(V-y), and 0.87(P-MR) and R-2=0.94, respectively. Human: Good reproducibility of coronary flow velocity was observed: ICC of 0.94/0.95(V-z), 0.76/0.74(V-x), and 0.80/0.77(V-y) at cardiac phase 1/2. Significant (p=0.025) increase in P-MR was observed in patients (6.404.43mmHg) versus controls (0.70 +/- 0.57mmHg).
ConclusionP(MR) in the coronary arteries is feasible. Upon further validation using the invasive measure, P-MR has the potential for noninvasive assessment of coronary artery stenosis. Magn Reson Med 77:529-537, 2017.

• 出版日期2017-2