Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results

Ley, Sebastian; Fink, Christian; Zaporozhan, J.; Borst, Mathias M.; Meyer, F. Joachim; Puderbach, Michael; Eichinger, Monika; Plathow, Christian; Grünig, Ekkehard; Kreitner, Karl‐Friedrich; Kauczor, Hans‐Ulrich

doi:10.1007/s00330-005-2792-z

Cited by 60 publications

(31 citation statements)

References 16 publications

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“…MRI was also superior in defining the exact central beginning of the thromboembolic material (45), a prerequisite for surgical thrombendarterectomy (44). As in acute PE, complementary MR perfusion should be performed to identify typical wedge-shaped perfusion defects, as opposed to patchy or diffuse defects in idiopathic PAH (46).…”

Section: Pulmonary Vasculaturementioning

confidence: 99%

MRI of the lung – state of the art

Wielpütz¹,

Kauczor²

2011

Diagn Interv Radiol

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118

136

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Section: Pulmonary Vasculaturementioning

confidence: 99%

MRI of the lung – state of the art

Wielpütz¹,

Kauczor²

2011

Diagn Interv Radiol

Self Cite

118

136

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“…As with the technical advances in CT, those in MR imaging have made it possible to obtain time-resolved or four-dimensional (4D) contrast-enhanced MR angiography or perfusion MRI from PTE patients (21)(22)(23)(24)(25). In addition, quantitative assessment of contrastenhanced perfusion MRI can help assess pulmonary physiology, pathophysiology, or disease severity of various pulmonary vascular diseases (22,(26)(27)(28).…”

mentioning

confidence: 99%

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

Ohno

Koyama

Matsumoto

et al. 2010

Magnetic Resonance Imaging

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Purpose: To compare directly the capabilities of multidetector-row computed tomography (MDCT) and MRI for disease severity assessment and outcome prediction for acute pulmonary thromboembolism (APTE) patients. Materials and Methods:Fifty consecutive APTE patients underwent MDCT, MR angiography, dynamic perfusion MRI, treatment and follow-up examination. Pulmonary blood flow (PBF), pulmonary blood volume, and mean transit time maps were generated from perfusion MRI, and all segmental parameters were determined by using region of interest measurements. Receiver operator curve analyses were used to determine the most accurate parameter for diagnosis of the APTE segment. Then, APTE index from perfusion MRI (PE perfusion MRI index), right ventricle/left ventricle (RV/LV) diameter ratio and APTE indexes from embolic burdens observed on MDCT (PE CT index) and MR angiography (PE MRA index) were calculated. Finally, ability to differentiate mortality (n ¼ 8) from survival (n ¼ 42) groups and to predict patient outcome were statistically assessed.Results: PBF was a significantly more accurate parameter than others (P < 0.05). When feasible threshold value was applied, specificity and accuracy of RV/LV diameter ratio and PE Perfusion MRI index were significantly higher than those of PE CT and PE MRA indexes (P < 0.05). Logistic regression analysis demonstrated that each index was a significant predictor (P < 0.05).Conclusion: Dynamic perfusion MRI can be effective for disease extent assessment and outcome prediction for APTE patients.

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“…shaped perfusion defects, while in PAH the perfusion is overall reduced and inhomogeneous [35]. Absolute quantification of perfusion enables the determination of pulmonary blood flow (PBF), blood volume (PBV) and mean transit time (MTT).…”

Section: Microcirculationmentioning

confidence: 99%

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) – Potential Role of Multidetector-Row CT (MD-CT) and MR Imaging in the Diagnosis and Differential Diagnosis of the Disease

Wirth

Brüggemann

Bostel

et al. 2014

Fortschr Röntgenstr

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Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension (resting mean pulmonary arterial pressure of 25?mm Hg or more determined at right heart catheterization) with persistent pulmonary perfusion defects. It is a rare, but underdiagnosed disease with estimated incidences ranging from 0.5?% to 3.8?% of patients after an acute pulmonary embolism (PE), and in up to 10?% of those with a history of recurrent PE. CTEPH is the only form of pulmonary hypertension that can be surgically treated leading to normalization of pulmonary hemodynamics and exercise capacity in the vast majority of patients. The challenges for imaging in patients with suspected CTEPH are fourfold: the imaging modality should have a high diagnostic accuracy with regard to the presence of CTEPH and allow for differential diagnosis. It should enable detection of patients suitable for PEA with great certainty, and allow for quantification of PH by measuring pulmonary hemodynamics (mPAP and PVR), and finally, it can be used for therapy monitoring. This overview tries to elucidate the potential role of ECG-gated multidetector CT pulmonary angiography (MD-CTPA) and MR imaging, and summarizes the most important results that have been achieved so far. Generally speaking, ECG-gated MD-CTPA is superior to MR in the assessment of parenchymal and vascular pathologies of the lung, and allows for the assessment of cardiac structures. The implementation of iodine maps as a surrogate for lung perfusion enables functional assessment of lung perfusion by CT. MR imaging is the reference standard for the assessment of right heart function and lung perfusion, the latter delineating typical wedge-shaped perfusion defects in patients with CTEPH. New developments show that with MR techniques, an estimation of hemodynamic parameters like mean pulmonary arterial pressure and pulmonary vascular resistance will be possible. CT and MR imaging should be considered as complementary investigations providing comprehensive information in patients with CTEPH. Citation Format: ??Wirth G, Br?ggemann K, Bostel T et?al. Chronic Thromboembolic Pulmonary Hypertension (CTEPH) ? Potential Role of Multidetector-Row CT (MD-CT) and MR Imaging in the Diagnosis and Differential Diagnosis of the Disease. Fortschr R?ntgenstr 2014; 186: 751???761

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Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results

Cited by 60 publications

References 16 publications

MRI of the lung – state of the art

MRI of the lung – state of the art

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) – Potential Role of Multidetector-Row CT (MD-CT) and MR Imaging in the Diagnosis and Differential Diagnosis of the Disease

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