Evaluation of aortic stenosis severity using 4D flow jet shear layer detection for the measurement of valve effective orifice area.
Evaluation of aortic stenosis severity using 4D flow jet shear layer detection for the measurement of valve effective orifice area.
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DOI：
10.1016/j.mri.2014.04.017
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发表时间：
2014-09
影响因子：
2.5
通讯作者：
Barker, Alex J.
中科院分区：
文献类型：
--
作者：
Garcia, Julio;Markl, Michael;Schnell, Susanne;Allen, Bradley;Entezari, Pegah;Mahadevia, Riti;Malaisrie, S. Chris;Pibarot, Philippe;Carr, James;Barker, Alex J.
本研究的目的是评价4D Flow MRI评估射流剪切层检测（JSLD）法确定的主动脉瓣狭窄患者瓣膜有效瓣口面积（EOA）的潜力。使用体外狭窄体模进行验证，并在10名健康对照和40名主动脉瓣狭窄患者中进行体内成像。使用标准2D相位对比MRI（PC-MRI）和4D血流MRI测量（分别为EOAJSLD-2D和EOAJSLD-4D），通过JSLD方法计算EOA。作为参考标准，使用连续性方程计算EOA（EOACE）和2D PC-MRI速度场，并与EOAJSLD测量值进行比较。对于0.9 - 3.7 m/s范围内的峰值速度，体外结果显示流动理论（EOA=0.78 cm 2）与实验测量值（EOAJSLD-4D=0.78±0.01 cm 2）之间具有极好的一致性。体内结果显示，EOAJSLD-2D与EOACE之间（r=0.91，p<0.001;偏倚：−0.01± 0.38 cm 2;一致性限值：0.75至− 0.77 cm 2）以及EOAJSLD-4D与EOACE之间（r=0.95，p<0.001;偏倚：−0.09± 0.26 cm 2;限值：0.43至− 0.62 cm 2）具有良好的相关性和一致性。本研究证明了使用4D Flow MRI测量EOAJSLD的可行性。该技术允许通过可视化3D缩静脉来优化EOA测量位置，并避免EOACE测量变异性的潜在来源。
The objective of this study was to evaluate the potential of 4D flow MRI to assess valve effective orifice area (EOA) in patients with aortic stenosis as determined by the jet shear layer detection (JSLD) method. An in-vitro stenosis phantom was used for validation and in-vivo imaging was performed in 10 healthy controls and 40 patients with aortic stenosis. EOA was calculated by the JSLD method using standard 2D phase contrast MRI (PC-MRI) and 4D flow MRI measurements (EOAJSLD-2D and EOAJSLD-4D, respectively). As a reference standard, the continuity equation was used to calculate EOA (EOACE) with the 2D PC-MRI velocity field and compared to the EOAJSLD measurements. The in-vitro results exhibited excellent agreement between flow theory (EOA=0.78 cm2) and experimental measurement (EOAJSLD-4D=0.78±0.01 cm2) for peak velocities ranging from 0.9 to 3.7 m/s. In-vivo results showed good correlation and agreement between EOAJSLD-2D and EOACE (r=0.91, p<0.001; bias: −0.01±0.38cm2; agreement limits: 0.75 to −0.77cm2), and between EOAJSLD-4D and EOACE (r=0.95, p<0.001; bias: −0.09±0.26cm2; limits: 0.43 to −0.62cm2). This study demonstrates the feasibility of measuring EOAJSLD using 4D flow MRI. The technique allows for optimization of the EOA measurement position by visualizing the 3D vena contracta, and avoids potential sources of EOACE measurement variability.
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影响因子：
4.4
作者：
Markl, Michael;Harloff, Andreas;Frydrychowicz, Alex
通讯作者：
Frydrychowicz, Alex
影响因子：
6.2
作者：
Garcia, Julio;Pibarot, Philippe;Larose, Eric
通讯作者：
Larose, Eric
影响因子：
5.7
作者：
Minners, Jan;Allgeier, Martin;Jander, Nikolaus
通讯作者：
Jander, Nikolaus
影响因子：
6.4
作者：
Garcia, Julio;Capoulade, Romain;Larose, Eric
通讯作者：
Larose, Eric
影响因子：
3.3
作者：
Lorenz, R.;Benk, C.;Markl, M.
通讯作者：
Markl, M.