Noninvasive measurement of intra-aneurysmal pressure and flow pattern using phase contrast with vastly undersampled isotropic projection imaging
Noninvasive measurement of intra-aneurysmal pressure and flow pattern using phase contrast with vastly undersampled isotropic projection imaging
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DOI：
10.3174/ajnr.a0648
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发表时间：
2007-10-01
影响因子：
3.5
通讯作者：
Mistretta, C. A.
中科院分区：
文献类型：
--
作者：
Moftakhar, R.;Aagaard-Kienitz, B.;Mistretta, C. A.
背景和目的：目前，需要更可靠的参数来预测动脉瘤破裂的风险。动脉瘤内压力梯度和血流图可以提供有关破裂风险的额外信息。我们的假设是，与侵入性测量相比，采用大幅欠采样各向同性投影重建 (PC-VIPR) 的相位对比（一种新型 3D MR 成像序列）可以准确评估犬动脉瘤模型中的动脉瘤内压力梯度。 材料和方法：本研究共纳入了 8 只犬科动物中的 13 个手术创建的动脉瘤。使用微导管对载瘤血管、动脉瘤颈部和动脉瘤囊内的 5 个区域进行压力测量。 PC-VIPR 序列用于获得覆盖整个动脉瘤区域的心脏门控速度测量值。然后将源自 PC-VIPR 数据的速度和压力梯度图与解剖 DSA 图像进行配准，并与导管测量结果进行比较。结果：在 7 个分叉动脉瘤中，速度流图显示了再循环流动模式，颈至穹顶压力梯度较小（平均 +0.5 mm Hg）。在 I 分叉动脉瘤中，观察到从颈部延伸到穹顶的射流，具有显着更大的压力梯度（+50.2 mm Hg）。所有侧壁动脉瘤的囊内流量较低，压力梯度中等（平均+8.3 mm Hg）。 PC-VIPR 动脉瘤压力与微导管压力测量之间存在高度统计相关性（R = 0.82，P < .01）。结论：PC-VIPR 可以在犬动脉瘤模型中提供解剖学以及无创定量和定性血流动力学信息。 PC-VIPR 动脉瘤内压力测量值与导管测量值相关性良好。
Background and Purpose: Currently, more reliable parameters to predict the risk of aneurysmal rupture are needed. Intra-aneurysmal pressure gradients and flow maps could provide additional information regarding the risk of rupture. Our hypothesis was that phase contrast with vastly under-sampled isotropic projection reconstruction (PC-VIPR), a novel 3D MR imaging sequence, could accurately assess intra-aneurysmal pressure gradients in a canine aneurysmal model when compared with invasive measurements.Materials and Methods: A total of 13 surgically created aneurysms in 8 canines were included in this study. Pressure measurements were performed in the parent vessel, aneurysm neck, and 5 regions within the aneurysmal sac with a microcatheter. PC-VIPR sequence was used to obtain cardiac-gated velocity measurements in a region covering the entire aneurysm. The velocity and pressure gradient maps derived from the PC-VIPR data were then coregistered with the anatomic DSA images and compared with catheter measurements.Results: In 7 of the bifurcation aneurysms, the velocity flow maps demonstrated a recirculation flow pattern with a small neck-to-dome pressure gradient (mean, +0.5 mm Hg). In I bifurcation aneurysm, a flow jet extending from the neck to the dome with significantly greater pressure gradient (+50.2 mm Hg) was observed. All sidewall aneurysms had low flow in the sac with intermediate pressure gradients (mean, +8.3 mm Hg). High statistical correlation existed between PC-VIPR aneurysmal pressures and microcatheter pressure measurements (R = 0.82, P < .01).Conclusion: PC-VIPR can provide anatomic as well as noninvasive quantitative and qualitative hemodynamic information in the canine aneurysm model. The PC-VIPR intra-aneurysmal pressure measurements correlated well with catheter measurements.