Noninvasive Measurement of Pressure Gradient Across a Coronary Stenosis using Phase Contrast -MRI

Deng Z et al.

Link: http://onlinelibrary.wiley.com/doi/10.1002/mrm.26579/abstract;jsessionid=F5BD8001D103F6F466CD3D0C2BD3025F.f03t03

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_MR ) and that obtained using pressure transducer (ΔP_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 ΔP_MR measurement across a coronary stenosis.

Results

Phantom: Good overall reproducibility of flow velocity and ΔP measurements and excellent correlation (ΔP_MR vs ΔP_PT ) was observed: intraclass correlation (ICC) of 0.95(V_z ), 0.72(V_x ), 0.73(V_y ), and 0.87(ΔP_MR ) and R² = 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 ΔP_MR was observed in patients (6.40 ± 4.43 mmHg) versus controls (0.70 ± 0.57 mmHg).

Conclusion

ΔP_MR in the coronary arteries is feasible. Upon further validation using the invasive measure, ΔP_MR has the potential for noninvasive assessment of coronary artery stenosis.