Validation of pressure drop assessment using 4D flow MRI-based turbulence production in various shapes of aortic stenoses
Validation of pressure drop assessment using 4D flow MRI-based turbulence production in various shapes of aortic stenoses
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DOI：
10.1002/mrm.27437
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发表时间：
2019-02-01
影响因子：
3.3
通讯作者：
Ebbers, Tino
中科院分区：
文献类型：
--
作者：
Ha, Hojin;Kvitting, John-Peder Escobar;Ebbers, Tino
目的：验证在不同形状的狭窄性狭窄中使用四维流动mri紊流产生的压降测量。方法：构建具有7种不同3d打印主动脉瓣几何形状的体外血流模型，并采用六向流编码（ICOSA6）的4D血流MRI扫描。基于简化伯努利、扩展伯努利、湍流产生和剪切尺度法，对阀内压降进行了无创预测。线性回归分析了预测结果与有创压降测量结果的一致性。结果：4D Flow MRI预测的压降与真实压降呈线性相关，但回归斜率不同。简化伯努利法的回归斜率和95%吻合范围分别为1.35和11.99 +/- 21.72 mm Hg，扩展伯努利法的回归斜率和95%吻合范围分别为1.02和0.74 +/- 8.48 mm Hg，湍流产生法的回归斜率和95%吻合范围分别为0.89和0.96 +/- 8.01 mm Hg。随着剪切尺度系数的变化，回归斜率在0.36 ~ 1.00之间变化。结论：基于紊流产生法的压降评估与扩展伯努利法和有创测量的不同形状主动脉瓣压降具有较好的一致性。基于湍流的压降估计可以作为传统伯努利方法的补充，在瓣膜疾病的评估中发挥作用。
Purpose: To validate pressure drop measurements using 4D flow MRI-based turbulence production in various shapes of stenotic stenoses.Methods: In vitro flow phantoms with seven different 3D-printed aortic valve geometries were constructed and scanned with 4D flow MRI with six-directional flow encoding (ICOSA6). The pressure drop through the valve was non-invasively predicted based on the simplified Bernoulli, the extended Bernoulli, the turbulence production, and the shear-scaling methods. Linear regression and agreement of the predictions with invasively measured pressure drop were analyzed.Results: All pressure drop predictions using 4D Flow MRI were linearly correlated to the true pressure drop but resulted in different regression slopes. The regression slope and 95% limits of agreement for the simplified Bernoulli method were 1.35 and 11.99 +/- 21.72 mm Hg. The regression slope and 95% limits of agreement for the extended Bernoulli method were 1.02 and 0.74 +/- 8.48 mm Hg. The regression slope and 95% limits of agreement for the turbulence production method were 0.89 and 0.96 +/- 8.01 mm Hg. The shear-scaling method presented good correlation with an invasively measured pressure drop, but the regression slope varied between 0.36 and 1.00 depending on the shear-scaling coefficient.Conclusion: The pressure drop assessment based on the turbulence production method agrees well with the extended Bernoulli method and invasively measured pressure drop in various shapes of the aortic valve. Turbulence-based pressure drop estimation can, as a complement to the conventional Bernoulli method, play a role in the assessment of valve diseases.