Noninvasive MRA-derived fractional flow for intracranial stenosis: methodological evaluation and hemodynamic insights - Summary - MDSpire

Noninvasive MRA-derived fractional flow for intracranial stenosis: methodological evaluation and hemodynamic insights

  • By

  • Xiaohui Wang

  • Haojing Zhu

  • Zhihua Du

  • Rongju Zhang

  • Yang Bian

  • Xinfeng Liu

  • Bin Lv

  • Rui Zhang

  • Jinhao Lyu

  • Xu Guan

  • Ziwei Guo

  • Xiangyu Cao

  • Jiawen Zhu

  • Rong Zou

  • Jianping Xiang

  • Shengyuan Yu

  • Jun Wang

  • June 29, 2026

  • 0 min

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Objective:

To evaluate a noninvasive fractional flow (FF) method derived from magnetic resonance angiography (MRA-FF) against established reference standards and assess its ability to reflect hemodynamically relevant impairment, including an exploratory assessment of its discriminative ability for hypoperfusion.

Approach:
  • Exploratory Analysis: Examined MRA-FF's ability to discriminate hypoperfusion using receiver operating characteristic (ROC) analysis in a subset of 38 patients with available perfusion imaging.
Key Findings:
  • 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 (p < 0.01).
  • MRA-FF was lower in patients with hypoperfusion compared to those without (p = 0.022).
  • The area under the ROC curve for discriminating hypoperfusion was 0.723.
Interpretation:

MRA-FF demonstrates good agreement with invasive and angiographic reference methods.

Limitations:
  • Study is retrospective and conducted at a single center.
  • Further external validation is required.
Conclusion:

MRA-FF shows potential as a fully noninvasive tool for functional assessment and hemodynamic characterization in ICAS.

Original Source(s)

Noninvasive MRA-derived fractional flow for intracranial stenosis: methodological evaluation and hemodynamic insights

  • by Xiaohui Wang, Haojing Zhu, Zhihua Du, Rongju Zhang, Yang Bian, Xinfeng Liu, Bin Lv, Rui Zhang, Jinhao Lyu, Xu Guan, Ziwei Guo, Xiangyu Cao, Jiawen Zhu, Rong Zou, Jianping Xiang, Shengyuan Yu, Jun Wang

  • June 29, 2026

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