Assessment of coronary blood flow in humans using phase difference MR imaging

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Abstract
Coronary blood flow quantification provides essential information on the hemodynamic significance of coronary artery stenoses. Recently, magnetic resonance (MR) flow mapping has emerged as a new promising method to noninvasively determine flow velocity and flow volume within the coronary arteries. The aim of this study was to compare phase difference (PD) MR flow quantification with intracoronary Doppler flow measurements in 15 patients with suspected or known coronary artery disease. Flow quantification was attempted before and after systemic application of 5mg Isosorbiddinitrate (ISDN) in order to determine possible alterations in coronary flow volume. PD MR flow mapping was performed successfully in 13 of the 15 patients. For flow velocities and flow volume values, a close correlation between PD MR and Doppler flow measurements was found (r = 0.79 and r = 0.90, respectively). However, average flow measured by PD MR was significantly lower than the invasively obtained values (9.0 ± 4.4 cm/sec vs. 11.7 ± 4.9 cm/sec; p<0.001 and 46.3 ± 28.7 ml/min vs. 53.4 ± 32.8 ml/min; p<0.05). Although the mean flow volume remained constant in the entire patient group after ISDN application, individual changes (increase in 6, decrease in 4 cases) could be documented with PD MR imaging and showed a good correlation to the Doppler method (r = 0.82). In conclusion, PD MR flow mapping is a promising method for the noninvasive quantification of coronary blood flow and therefore offers the potential of assessing coronary artery stenoses. However, technical improvements are mandatory in order to increase accuracy of the method.

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