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Magn Reson Med. 2017 Feb;77(2):529-537. doi: 10.1002/mrm.26579. Epub 2016 Dec 26.

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

Author information

1
Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.
2
Department of Bioengineering, University of California, Los Angeles, California, USA.
3
Division of Cardiology, Severance Cardiovascular Hospital, Seoul, South Korea.
4
Siemens Healthcare R&D, Los Angeles, USA.
5
Department of Radiology, Severance Hospital, Seoul, South Korea.
6
Department of Medicine, University of California, Los Angeles, California, USA.

Abstract

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 (ΔPMR ) and that obtained using pressure transducer (ΔPPT ) 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 ΔPMR measurement across a coronary stenosis.

RESULTS:

Phantom: Good overall reproducibility of flow velocity and ΔP measurements and excellent correlation (ΔPMR vs ΔPPT ) was observed: intraclass correlation (ICC) of 0.95(Vz ), 0.72(Vx ), 0.73(Vy ), and 0.87(ΔPMR ) and R2  = 0.94, respectively. Human: Good reproducibility of coronary flow velocity was observed: ICC of 0.94/0.95(Vz ), 0.76/0.74(Vx ), and 0.80/0.77(Vy ) at cardiac phase 1/2. Significant (p = 0.025) increase in ΔPMR was observed in patients (6.40 ± 4.43 mmHg) versus controls (0.70 ± 0.57 mmHg).

CONCLUSION:

ΔPMR in the coronary arteries is feasible. Upon further validation using the invasive measure, ΔPMR 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.

KEYWORDS:

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

PMID:
28019028
PMCID:
PMC5556934
DOI:
10.1002/mrm.26579
[Indexed for MEDLINE]
Free PMC Article

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