MRI‐based computational fluid dynamics for diagnosis and treatment prediction: Clinical validation study in patients with coarctation of aorta

作者：Leonid Goubergrits, Eugénie Riesenkampff, Pavlo Yevtushenko, J. Schaller, Ulrich Kertzscher, Anja Hennemuth, Felix Berger, Stephan Schubert, Titus Kühne · 发表于：Journal of Magnetic Resonance Imaging · 年份：2014 · DOI：10.1002/jmri.24639 · 被引用次数：108 · 研究领域：Advanced MRI Techniques and Applications、Congenital Heart Disease Studies、Cerebrospinal fluid and hydrocephalus

PURPOSE: To reduce the need for diagnostic catheterization and optimize treatment in a variety of congenital heart diseases, magnetic resonance imaging (MRI)-based computational fluid dynamics (CFD) is proposed. However, data about the accuracy of CFD in a clinical context are still sparse. To fill this gap, this study compares MRI-based CFD to catheterization in the coarctation of aorta (CoA) setting. MATERIALS AND METHODS: Thirteen patients with CoA were investigated by routine MRI prior to catheterization. 3D whole-heart MRI was used to reconstruct geometries and 4D flow-sensitive phase-contrast MRI was used to acquire flows. Peak systolic flows were simulated using the program FLUENT. RESULTS: Peak systolic pressure drops in CoA measured by catheterization and CFD correlated significantly for both pre- and posttreatment measurements (pre: r = 0.98, p = 0.00; post: r = 0.87, p = 0.00). The pretreatment bias was -0.5 ± 3.33 mmHg (95% confidence interval -2.55 to 1.47 mmHg). CFD predicted a reduction of the peak systolic pressure drop after treatment that ranged from 17.6 ± 5.56 mmHg to 6.7 ± 5.58 mmHg. The posttreatment bias was 3.0 ± 2.91 mmHg (95% CI -1.74 to 5.43 mmHg). CONCLUSION: Peak systolic pressure drops can be reliably calculated using MRI-based CFD in a clinical setting. Therefore, CFD might be an attractive noninvasive alternative to diagnostic catheterization.