Magnetic resonance quantification of the myocardial perfusion reserve with a Fermi function model for constrained deconvolution
Magnetic resonance quantification of the myocardial perfusion reserve with a Fermi function model for constrained deconvolution
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DOI：
10.1118/1.598163
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发表时间：
1998-01-01
期刊：
影响因子：
3.8
通讯作者：
Wilson, RF
中科院分区：
文献类型：
--
作者：
Jerosch-Herold, M;Wilke, N;Wilson, RF
心肌灌注储备，定义为充血心肌血流量与基础心肌血流量的比率，是反映冠状动脉病变功能意义的有用指标。快速磁共振成像用于无创检测团注造影剂作为MR示踪剂，用于测量静息和充血时微血管功能障碍患者的局部组织灌注量。心肌内示踪剂滞留时间分布的费米函数模型被用来拟合MR信号曲线。心肌灌注储备是根据静息和充血时的脉冲反应幅度计算的。模型的假设通过蒙特卡罗模拟得到验证，该模型使用多路径、轴向分布的血液组织交换的数学模型，该模型允许血液流量、血管容量和毛细血管通透性的系统变化。对于6：1的对比度噪声比，在每克组织的对比度为0.5到4.0ml/min的范围内，如果输入函数的平均通过时间小于约9 S，则充血和基底行的脉冲响应幅度的比率与模型血流的比率成线性正比。在低(1.0ml/min/g)和高(3-4ml/min/g)血流时，血流储备估计的不确定性都会增加。蒙特卡罗模拟的预测结果与MR First Pass研究的结果一致，在无明显冠状动脉病变和微血管功能障碍的患者中，左前降支(LAD)区域的血流储备与LAD内的多普勒超声储备呈线性相关(r=0.84)，与先前的PET研究一致。(C)1998年美国医学物理学家协会。
The myocardial perfusion reserve, defined as the ratio of hyperemic and basal myocardial blood flow, is a useful indicator of the functional significance of a coronary artery lesion. Rapid magnetic resonance (MR) imaging for the noninvasive detection of a bolus-injected contrast agent as a MR tracer is applied to the measurement of regional tissue perfusion during rest and hyperemia, in patients with microvascular dysfunction. A Fermi function model for the distribution of tracer residence times in the myocardium is used to fit the MR signal curves. The myocardial perfusion reserve is calculated from the impulse response amplitudes for rest and hyperemia. The assumptions of the model are tested with Monte Carlo simulations, using a multiple path, axially distributed mathematical model of blood tissue exchange, which allows for systematic variation of blood flow, vascular volume, and capillary permeability. For a contrast-to-noise ratio of 6:1, and over a range of hows from 0.5 to 4.0 ml/min per g of tissue, the ratio of the impulse response amplitudes for hyperemic and basal Rows is linearly proportional to the ratio of model blood flows, if the mean transit time of the input function is shorter than approximately 9 s. The uncertainty in the blood flow reserve estimates grows both at low (< 1.0 ml/min/g) and high (> 3-4 ml/min/g) flows. The predictions of the Monte Carlo simulations agree with the results of MR first pass studies in patients without significant coronary artery lesions and microvascular dysfunction, where the perfusion reserve in the territory of the left anterior descending coronary artery (LAD) correlates linearly with the intracoronary Doppler ultrasound flow reserve in the LAD (r = 0.84), in agreement with previous PET studies. (C) 1998 American Association of Physicists in Medicine.