Evaluation of 4D flow MRI-based non-invasive pressure assessment in aortic coarctations.
J Biomech
; 94: 13-21, 2019 Sep 20.
Article
em En
| MEDLINE
| ID: mdl-31326119
ABSTRACT
Severity of aortic coarctation (CoA) is currently assessed by estimating trans-coarctation pressure drops through cardiac catheterization or echocardiography. In principle, more detailed information could be obtained non-invasively based on space- and time-resolved magnetic resonance imaging (4D flow) data. Yet the limitations of this imaging technique require testing the accuracy of 4D flow-derived hemodynamic quantities against other methodologies. With the objective of assessing the feasibility and accuracy of this non-invasive method to support the clinical diagnosis of CoA, we developed an algorithm (4DF-FEPPE) to obtain relative pressure distributions from 4D flow data by solving the Poisson pressure equation. 4DF-FEPPE was tested against results from a patient-specific fluid-structure interaction (FSI) simulation, whose patient-specific boundary conditions were prescribed based on 4D flow data. Since numerical simulations provide noise-free pressure fields on fine spatial and temporal scales, our analysis allowed to assess the uncertainties related to 4D flow noise and limited resolution. 4DF-FEPPE and FSI results were compared on a series of cross-sections along the aorta. Bland-Altman analysis revealed very good agreement between the two methodologies in terms of instantaneous data at peak systole, end-diastole and time-averaged values biases (means of differences) were +0.4â¯mmHg, -1.1â¯mmHg and +0.6â¯mmHg, respectively. Limits of agreement (2 SD) were ±0.978â¯mmHg, ±1.06â¯mmHg and ±1.97â¯mmHg, respectively. Peak-to-peak and maximum trans-coarctation pressure drops obtained with 4DF-FEPPE differed from FSI results by 0.75â¯mmHg and -1.34â¯mmHg respectively. The present study considers important validation aspects of non-invasive pressure difference estimation based on 4D flow MRI, showing the potential of this technology to be more broadly applied to the clinical practice.
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Base de dados:
MEDLINE
Assunto principal:
Coartação Aórtica
/
Imageamento por Ressonância Magnética
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Modelos Cardiovasculares
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Biomech
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Reino Unido