The mechanisms of arterial signal intensity profile in non-contrast coronary MRA (NC-MRCA): a 3D printed phantom investigation and clinical translations

Yoko Kato, Chikara Noda, Bharath Ambale-Venkatesh, Jason M. Ortman, Yoshimori Kassai, Joao A.C. Lima, Chia Ying Liu

Research output: Contribution to journalArticlepeer-review

Abstract

Signal intensity (SI) drop has been proposed as an indirect stenosis assessment in non-contrast coronary MRA (NC-MRCA) but it uses unproven assumptions. We aimed to clarify the mechanisms that govern the SI in vitro and develop a stenosis detection method in vivo. Flow phantom tubes with/without stenosis were scanned under two spatial resolutions (0.5/1.0 mm3) on a 3.0 T MRI. Thirty-two coronary arteries from 11 volunteers were prospectively scanned with an EKG- and respiratory-gated 3D NC-MRCA with a resolution of 1.0 mm3, with coronary computed tomography angiography (CTA) as reference. The normalized SI along the centerline of the tubes or the coronary arteries was assessed against the distance from the orifice using a linear regression model. Its coefficient (SI decay slope) and goodness-of-fit (R2) were extracted to assess the effect of flow velocity and stenosis on the SI profile curve. The R2 was utilized for the stenosis detection. Phantom study: A slow flow velocity caused a steep SI decay slope. The SI drop revealed only at the inlet and outlet of stenosis due to the flow turbulence/vortex and yielded low R2, in which shape changed by the resolution. Clinical study: The R2 cutoff to detect ≥ 50% stenosis for the left and right coronary arteries were 0.64 and 0.20 with a sensitivity/specificity of 71.5/71.5 and 66.7/100 (%), respectively. The SI drop did not reflect the actual stenosis position and not suitable for the stenosis localization. The R2 cutoff represents an alternative method to detect stenoses on NC-MRCA at vessel level. Trial registration: ClinicalTrials.gov; NCT03768999, registered on December 7, 2018.

Original languageEnglish (US)
Pages (from-to)209-220
Number of pages12
JournalInternational Journal of Cardiovascular Imaging
Volume39
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • 3D-printed phantom
  • Coronary stenosis detection
  • Deep learning-based denoising
  • Non-contrast coronary MRA
  • SI profile curve
  • Transluminal attenuation gradient (TAG)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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