Pulmonary Arterial Hypertension: Noninvasive Detection with Phase-Contrast MR Imaging

Sanz, Javier; Kuschnir, Paola; Rius, Teresa; Salguero, Rafael; Sulica, Roxana; Einstein, Andrew J.; Dellegrottaglie, Santo; Fuster, Valentín; Rajagopalan, Sanjay; Poon, Michael

doi:10.1148/radiol.2431060477

Cited by 209 publications

(173 citation statements)

References 39 publications

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“…several studies have shown the potential use of a variety of phase-contrast MR imaging-derived parameters in the evaluation of pulmonary hypertension ( 28,29 ). A combined MR protocol, which might include pulmonary fl ow information derived from phasecontrast imaging in addition to perfusion and angiographic information provided by contrast-enhanced techniques, may be helpful for assessing the global pulmonary circulation status in patients with different types of pulmonary hypertension.…”

Section: Referencesmentioning

confidence: 99%

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Sergiacomi

Bolacchi²,

Cadioli³

et al. 2010

Radiology

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Purpose:To correlate conventional invasive pressure indexes of pulmonary circulation with pulmonary fi rst-order arterial mean transit time (MTT) and time to peak enhancement (TTP) measured by means of three-dimensional timeresolved magnetic resonance (MR) angiography in patients with combined pulmonary fi brosis and emphysema (CPFE). Materials and Methods:The study was institutional review board approved. All subjects involved in the study provided written informed consent. Eighteen patients with CPFE were enrolled in this study. Thirteen healthy individuals matched for age and sex served as control subjects. Three-dimensional timeresolved MR angiography was performed by using a 3.0-T MR imager. Regions of interest (ROIs) were drawn manually on fi rst-order pulmonary arteries. Within the ROIs, signal intensity-versus-time curves refl ecting the fi rst pass of the contrast agent bolus in the pulmonary vessels were obtained. MTT and TTP were calculated. Pulmonary arterial pressure and pulmonary capillary wedge pressure were measured with a double-lumen, balloon-tipped catheter that was positioned in the pulmonary artery. The mean pulmonary arterial pressure (mPAP) and the pulmonary vascular resistance (PVR) were determined. Results:MTT and TTP values were prolonged signifi cantly in patients with CPFE compared with those in the control subjects ( P , .001). Mean TTP and mean MTT correlated directly with mPAP and PVR index ( P , .005). At multiple linear regression analysis, MTT was the only factor independently associated with PVR index and mPAP. Conclusion:Three-dimensional time-resolved MR angiography enables determination of pulmonary hemodynamic parameters that correlate signifi cantly with the pulmonary hemodynamic parameters obtained with invasive methods and may represent a complementary tool for evaluating pulmonary hypertension in patients with CPFE.

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Section: Referencesmentioning

confidence: 99%

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Sergiacomi

Bolacchi²,

Cadioli³

et al. 2010

Radiology

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“…Investigators in a 2007 study 15 examined 59 PH patients who underwent both right-sided heart catheterization and phase-contrast MRI. The average PA velocity had the best correlation with mean PA pressure, systolic PA pressure, and PVR index.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in Pediatric Pulmonary Hypertension

Pektas¹,

Olguntürk²,

Çevik³

et al. 2015

Texas Heart Institute Journal

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The present study aims to determine the efficacy and reliability of cardiovascular magnetic resonance imaging in establishing the diagnosis and prognosis of pulmonary hypertension in children. This is a retrospective comparison of 25 children with pulmonary hypertension and a control group comprising 19 healthy children. The diagnosis of pulmonary hypertension was made when the mean pulmonary artery pressure was ≥25 mmHg by catheter angiography. The children with pulmonary hypertension had significantly lower body mass indices than did the healthy children (P=0.048). In addition, the children with pulmonary hypertension had significantly larger main pulmonary artery diameters and ascending aortic diameters (both P=0.001) but statistically similar ratios of main pulmonary artery diameter-to-ascending aortic diameter. If the main pulmonary artery diameter was ≥25 mm, pediatric pulmonary hypertension was diagnosed with 72% sensitivity and 84% specificity. In the event that the ratio of main pulmonary artery diameter-to-ascending aorta diameter was ≥1, pediatric pulmonary hypertension was diagnosed with 60% sensitivity and 53% specificity. When compared with children who had New York Heart Association functional class II pulmonary hypertension, the children with functional class III pulmonary hypertension had significantly larger main (P=0.046), right (P=0.036), and left (P=0.003) pulmonary arteries. Cardiovascular magnetic resonance imaging is useful in the diagnosis of children with pulmonary hypertension. Pediatric pulmonary hypertension can be diagnosed with high sensitivity and specificity when the main pulmonary artery diameter measures ≥25 mm.

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“…15,16 Stroke volume (SV), a useful measure for PAH, can be calculated with pulmonary arterial ‰ow. Long-term follow-up suggests that a 10-mL change in SV is clinically important in patients with PAH.…”

Section: Evaluation Of Pulmonary Circulation Using Phase-contrast Cinmentioning

confidence: 99%

“…17 Several parameters, including acceleration time, acceleration volume, ratio, and average velocity, have been proposed for quantitative analysis of the time-velocity curve. 16 Sanz and colleagues 16 assessed the diagnostic value of these parameters in PAH in 59 subjects and found that average velocity correlated best with mPAP. PAH was correctly diagnosed with average velocity above the cutoŠ value of 11.7 cm/s (measured in expiration), with sensitivity of 92.9z (39/42) and speciˆcity of 82.4z (14/17).…”

Section: Evaluation Of Pulmonary Circulation Using Phase-contrast Cinmentioning

confidence: 99%

“…In addition, blood ‰ow measured with breath-hold MR imaging may diŠer from physiological blood ‰ow during normal breathing because breath-holding can change intrathoracic pressure and thereby considerably in‰uence systemic venous return to the heart. 22 Sanz's group 16 obtained phase-contrast images during end-expiratory breath holds preceded by brief hyperventilation. …”

Section: T Iwasawamentioning

confidence: 99%

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Diagnosis and Management of Pulmonary Arterial Hypertension using MR Imaging

Iwasawa

2013

magn reson med sci

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Pulmonary arterial hypertension (PAH) is a syndrome that results from restricted blood ‰ow through the pulmonary arterial circulation, which leads to a pathological increase in pulmonary vascular resistance (PVR) and ultimately to right heart failure. The prognosis of patients with PAH has improved with the recent development of new medications. The need for new noninvasive diagnostic tools is increasing. Magnetic resonance (MR) imaging is the gold standard for assessing the right ventricle (RV). Its high degree of reproducibility makes it ideal for monitoring changes in RV parameters in response to therapy. MR imaging can also provide both anatomical and functional information about pulmonary hemodynamics. This article reviews the current status of MR imaging of the right side of the heart and pulmonary circulation in patients with PAH and other associated pulmonary diseases.

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Pulmonary Arterial Hypertension: Noninvasive Detection with Phase-Contrast MR Imaging

Abstract: The average blood velocity throughout the cardiac cycle is strongly correlated with pulmonary pressures and resistance.

Cited by 209 publications

References 39 publications

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Magnetic Resonance Imaging in Pediatric Pulmonary Hypertension

Diagnosis and Management of Pulmonary Arterial Hypertension using MR Imaging

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