ArticleFrontiers in neurology2026
Noninvasive MRA-derived fractional flow for intracranial stenosis: methodological evaluation and hemodynamic insights.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Current fractional flow (FF) approaches in quantifying the hemodynamic severity of intracranial atherosclerotic stenosis (ICAS) are invasive or require angiography. This study primarily evaluated a noninvasive FF method derived from magnetic resonance angiography (MRA-FF) against established reference standards, with an exploratory assessment of its ability to reflect hemodynamically relevant impairment. Methods: In this retrospective study of 50 patients with ICAS, MRA-FF was computed from 3D vascular models using patient-specific flow boundary conditions. Agreement with invasive pressure-wire-derived FF (PW-FF, Results: MRA-FF showed moderate-to-good agreement with PW-FF (ICC = 0.743; 95% CI, 0.437-0.895) and good agreement with DSA-FF (ICC = 0.784; 95% CI, 0.649-0.871). Equivalence to DSA-FF was confirmed by TOST (90% CI of difference, -0.016 to 0.035; Conclusion: MRA-FF demonstrates good agreement with invasive and angiographic reference methods and shows the ability to discriminate hypoperfusion in an exploratory analysis. These findings support the feasibility and potential clinical utility of a fully noninvasive FF approach for functional assessment and hemodynamic characterization, although further external validation is required.
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