Quantitative assessment of myocardial blood flow in coronary artery disease by cardiovascular magnetic resonance: comparison of Fermi and distributed parameter modeling against invasive methods

Journal of Cardiovascular Magnetic Resonance

Research

Shirjel Alam¹  Marc R. Dweck¹  Michelle C. Williams¹  Saeed Mirsadraee²  Annette Cooper²  Giorgos Papanastasiou³  Scott I. Semple³  David E. Newby³ 

[1] Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK;Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK;Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK;Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK;

关键词: Cardiovascular magnetic resonance;    Myocardial blood flow;    Fermi modeling;    Distributed parameter modeling;    Invasive methods;   

DOI  :  10.1186/s12968-016-0270-1

 received in 2016-03-31, accepted in 2016-07-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundMathematical modeling of perfusion cardiovascular magnetic resonance (CMR) data allows absolute quantification of myocardial blood flow and can potentially improve the diagnosis and prognostication of obstructive coronary artery disease (CAD), against the current clinical standard of visual assessments. This study compares the diagnostic performance of distributed parameter modeling (DP) against the standard Fermi model, for the detection of obstructive CAD, in per vessel against per patient analysis.MethodsA pilot cohort of 28 subjects (24 included in the final analysis) with known or suspected CAD underwent adenosine stress-rest perfusion CMR at 3T. Data were analysed using Fermi and DP modeling against invasive coronary angiography and fractional flow reserve, acquired in all subjects. Obstructive CAD was defined as luminal stenosis of ≥70 % alone, or luminal stenosis ≥50 % and fractional flow reserve ≤0.80.ResultsOn ROC analysis, DP modeling outperformed the standard Fermi model, in per vessel and per patient analysis. In per patient analysis, DP modeling-derived myocardial blood flow at stress demonstrated the highest sensitivity and specificity (0.96, 0.92) in detecting obstructive CAD, against Fermi modeling (0.78, 0.88) and visual assessments (0.79, 0.88), respectively.ConclusionsDP modeling demonstrated consistently increased diagnostic performance against Fermi modeling and showed that it may have merit for stratifying patients with at least one vessel with obstructive CAD.Trial RegistrationClinical Trial Registration: Clinicaltrials.gov NCT01368237Registered 6 of June 2011. URL: https://clinicaltrials.gov/ct2/show/NCT01368237

【 授权许可】

CC BY   
© The Author(s). 2016