Document Detail


Noninvasive Assessment of Transstenotic Pressure Gradients in Porcine Renal Artery Stenoses by Using Vastly Undersampled Phase-Contrast MR Angiography.
MedLine Citation:
PMID:  21813739     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose: To compare noninvasive transstenotic pressure gradient (TSPG) measurements derived from high-spatial- and temporal-resolution four-dimensional magnetic resonance (MR) flow measurements with invasive measurements obtained from endovascular pressure wires with digital subtraction angiographic guidance. Materials and Methods: After Animal Care and Use Committee approval, bilateral renal artery stenosis (RAS) was created surgically in 12 swine. Respiratory-gated phase-contrast vastly undersampled isotropic projection (VIPR) MR angiography of the renal arteries was performed with a 1.5-T clinical MR system (repetition time, 11.4 msec; echo time [first echo], 3.7 msec; 18 000 projection angles; imaging volume, 260 × 260 × 200 mm; acquired isotropic spatial resolution, 1.0 × 1.0 × 1.0 mm; velocity encoding, 150 cm/sec). Velocities measured with phase-contrast VIPR were used to calculate TSPGs by using Navier-Stokes equations. These were compared with endovascular pressure measurements (mean and peak) performed by using fluoroscopic guidance with regression analysis. Results: In 19 renal arteries with an average stenosis of 62% (range, 0%-87%), there was excellent correlation between the noninvasive TSPG measurement with phase-contrast VIPR and invasive TSPG measurement for mean TSPG (R(2) = 95.4%) and strong correlation between noninvasive TSPG and invasive TSPG for the peak TSPG measures (R(2) = 82.6%). The phase-contrast VIPR-derived TSPG measures were slightly lower than the endovascular measurements. In four arteries with severe stenoses and one occlusion (mean, 86%; range, 75%-100%), the residual lumen within the stenosis was too small to determine TSPG with phase-contrast VIPR. Conclusion: The unenhanced MR angiographic technique with phase-contrast VIPR allows for accurate noninvasive assessment of hemodynamic significance in a porcine model of RAS with highly accurate TSPG measurements. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101175/-/DC1.
Authors:
Thorsten A Bley; Kevin M Johnson; Christopher J François; Scott B Reeder; Mark L Schiebler; Benjamin R Landgraf; Daniel Consigny; Thomas M Grist; Oliver Wieben
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-3
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Radiology, Medical Physics, Biomedical Engineering, and Medicine, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Room 1127 WIMR, Madison, WI 53705-2275.
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