Patient-specific requirements and clinical validation of MRI-based pressure mapping: A two-center study in patients with aortic coarctation.
Adolescent
Adult
Aortic Coarctation
/ diagnostic imaging
Artifacts
Cardiac Catheterization
Catheters
Child
Female
Heart
/ diagnostic imaging
Humans
Image Processing, Computer-Assisted
/ methods
Imaging, Three-Dimensional
/ methods
Magnetic Resonance Imaging
Male
Middle Aged
Poisson Distribution
Pressure
Prospective Studies
Reproducibility of Results
Risk
Young Adult
4D VEC MRI
aortic coarctation
catheterization
congenital heart disease
image-based cardiovascular modeling
noninvasive diagnostics
Journal
Journal of magnetic resonance imaging : JMRI
ISSN: 1522-2586
Titre abrégé: J Magn Reson Imaging
Pays: United States
ID NLM: 9105850
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
03
03
2018
accepted:
25
05
2018
pubmed:
6
11
2018
medline:
24
3
2020
entrez:
4
11
2018
Statut:
ppublish
Résumé
Invasive peak-to-peak pressure gradients are the current clinical reference standard for assessing aortic coarctation. To obtain them, patients need to undergo arterial heart catheterization. Unless an intervention is performed, the procedure remains purely diagnostic, while the concomitant risks remain. To validate MRI-based pressure mapping against pressure drop derived from heart catheterization and to define minimal clinical requirements. Prospective clinical validation study. Twenty-seven coarctation patients with an indicated heart catheterization were enrolled at two clinical centers. 1.5T including 4D velocity-encoded MRI and 3D anatomical imaging of the aorta. Pressure drop across the stenosis was calculated by pressure mapping based on the pressure Poisson equation. Calculated pressure drops were compared with catheter measured data. Spatial and temporal resolution were analyzed using in silico phantom-based data as well as in vivo measurements. Pressure drop was compared to peak-to-peak measurements. A two-sample paired mean equivalence test was used. In patients without imaging artifacts and a required spatial resolution ≥5 voxel/diameter, significant equivalence of pressure mapping compared to heart catheterization was found (17.5 ± 6.49 vs. 16.6 ± 6.53 mmHg, P < 0.001). Pressure mapping provides equivalent accuracy to pressure drop obtained from heart catheterization in patients 1) without previous stenting and 2) with sufficient spatial image resolution (at least 5 voxels/diameter). In these patients the method can reliably be performed prior to the actual procedure, and thus allows safe noninvasive treatment planning based on MRI. 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:81-89.
Sections du résumé
BACKGROUND
Invasive peak-to-peak pressure gradients are the current clinical reference standard for assessing aortic coarctation. To obtain them, patients need to undergo arterial heart catheterization. Unless an intervention is performed, the procedure remains purely diagnostic, while the concomitant risks remain.
PURPOSE
To validate MRI-based pressure mapping against pressure drop derived from heart catheterization and to define minimal clinical requirements.
STUDY TYPE
Prospective clinical validation study.
POPULATION
Twenty-seven coarctation patients with an indicated heart catheterization were enrolled at two clinical centers.
MRI SEQUENCES
1.5T including 4D velocity-encoded MRI and 3D anatomical imaging of the aorta.
ASSESSMENT
Pressure drop across the stenosis was calculated by pressure mapping based on the pressure Poisson equation. Calculated pressure drops were compared with catheter measured data. Spatial and temporal resolution were analyzed using in silico phantom-based data as well as in vivo measurements.
STATISTICS
Pressure drop was compared to peak-to-peak measurements. A two-sample paired mean equivalence test was used.
RESULTS
In patients without imaging artifacts and a required spatial resolution ≥5 voxel/diameter, significant equivalence of pressure mapping compared to heart catheterization was found (17.5 ± 6.49 vs. 16.6 ± 6.53 mmHg, P < 0.001).
DATA CONCLUSION
Pressure mapping provides equivalent accuracy to pressure drop obtained from heart catheterization in patients 1) without previous stenting and 2) with sufficient spatial image resolution (at least 5 voxels/diameter). In these patients the method can reliably be performed prior to the actual procedure, and thus allows safe noninvasive treatment planning based on MRI.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:81-89.
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-89Informations de copyright
© 2018 International Society for Magnetic Resonance in Medicine.