Pulmonary hypertension MRI: Difference between revisions
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===Role of MRI=== | ===Role of MRI=== | ||
The role of MRI:<ref name="pmid24344668">{{cite journal |vauthors=Alassas K, Mergo P, Ibrahim el-S, Burger C, Safford R, Parikh P, Shapiro B |title=Cardiac MRI as a diagnostic tool in pulmonary hypertension |journal=Future Cardiol |volume=10 |issue=1 |pages=117–30 |date=January 2014 |pmid=24344668 |doi=10.2217/fca.13.97 |url=}}</ref><ref name="pmid25145313">{{cite journal |vauthors=Lungu A, Wild JM, Capener D, Kiely DG, Swift AJ, Hose DR |title=MRI model-based non-invasive differential diagnosis in pulmonary hypertension |journal=J Biomech |volume=47 |issue=12 |pages=2941–7 |date=September 2014 |pmid=25145313 |doi=10.1016/j.jbiomech.2014.07.024 |url=}}</ref><ref name="pmid25161042">{{cite journal |vauthors=Ohira H, Beanlands RS, Davies RA, Mielniczuk L |title=The role of nuclear imaging in pulmonary hypertension |journal=J Nucl Cardiol |volume=22 |issue=1 |pages=141–57 |date=February 2015 |pmid=25161042 |doi=10.1007/s12350-014-9960-y |url=}}</ref><ref name="pmid23863980">{{cite journal |vauthors=Kreitner KF, Wirth GM, Krummenauer F, Weber S, Pitton MB, Schneider J, Mayer E, Dueber C |title=Noninvasive assessment of pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension by high temporal resolution phase-contrast MRI: correlation with simultaneous invasive pressure recordings |journal=Circ Cardiovasc Imaging |volume=6 |issue=5 |pages=722–9 |date=September 2013 |pmid=23863980 |doi=10.1161/CIRCIMAGING.112.000276 |url=}}</ref><ref name="pmid24756429">{{cite journal |vauthors=Wirth G, Brüggemann K, Bostel T, Mayer E, Düber C, Kreitner KF |title=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 |journal=Rofo |volume=186 |issue=8 |pages=751–61 |date=August 2014 |pmid=24756429 |doi=10.1055/s-0034-1366425 |url=}}</ref> | The role of MRI:<ref name="pmid24344668">{{cite journal |vauthors=Alassas K, Mergo P, Ibrahim el-S, Burger C, Safford R, Parikh P, Shapiro B |title=Cardiac MRI as a diagnostic tool in pulmonary hypertension |journal=Future Cardiol |volume=10 |issue=1 |pages=117–30 |date=January 2014 |pmid=24344668 |doi=10.2217/fca.13.97 |url=}}</ref><ref name="pmid25145313">{{cite journal |vauthors=Lungu A, Wild JM, Capener D, Kiely DG, Swift AJ, Hose DR |title=MRI model-based non-invasive differential diagnosis in pulmonary hypertension |journal=J Biomech |volume=47 |issue=12 |pages=2941–7 |date=September 2014 |pmid=25145313 |doi=10.1016/j.jbiomech.2014.07.024 |url=}}</ref><ref name="pmid25161042">{{cite journal |vauthors=Ohira H, Beanlands RS, Davies RA, Mielniczuk L |title=The role of nuclear imaging in pulmonary hypertension |journal=J Nucl Cardiol |volume=22 |issue=1 |pages=141–57 |date=February 2015 |pmid=25161042 |doi=10.1007/s12350-014-9960-y |url=}}</ref><ref name="pmid23863980">{{cite journal |vauthors=Kreitner KF, Wirth GM, Krummenauer F, Weber S, Pitton MB, Schneider J, Mayer E, Dueber C |title=Noninvasive assessment of pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension by high temporal resolution phase-contrast MRI: correlation with simultaneous invasive pressure recordings |journal=Circ Cardiovasc Imaging |volume=6 |issue=5 |pages=722–9 |date=September 2013 |pmid=23863980 |doi=10.1161/CIRCIMAGING.112.000276 |url=}}</ref><ref name="pmid24756429">{{cite journal |vauthors=Wirth G, Brüggemann K, Bostel T, Mayer E, Düber C, Kreitner KF |title=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 |journal=Rofo |volume=186 |issue=8 |pages=751–61 |date=August 2014 |pmid=24756429 |doi=10.1055/s-0034-1366425 |url=}}</ref> | ||
*Accurate evaluation of the size, morphology and function of the right ventricle. | *Accurate evaluation of the size, morphology and function of the [[right ventricle]]. | ||
**MRI has similar abilities to those of [[echocardiography]] in the diagnosis and treatment of patients with pulmonary hypertension. | **MRI has similar abilities to those of [[echocardiography]] in the diagnosis and treatment of patients with pulmonary hypertension. | ||
*Detection of shunts contributing to pulmonary hypertension. | *Detection of shunts contributing to pulmonary hypertension. | ||
*Detection of acute and chronic pulmonary thromboembolic disease. | *Detection of acute and chronic pulmonary [[thromboembolic]] disease. | ||
*Differentiation between the pulmonary vasculature and [[mediastinal]] [[adenopathy]] when used for contrast enhancement. | *Differentiation between the pulmonary [[vasculature]] and [[mediastinal]] [[adenopathy]] when used for contrast enhancement. | ||
*Follow-up for right heart [[hemodynamics]]. | *Follow-up for right heart [[hemodynamics]]. | ||
**Poor right ventricular function is indicated by the following according to the ACCF/AHA 2009 | **Poor right ventricular function is indicated by the following according to the ACCF/AHA 2009 expert consensus document on pulmonary hypertension: | ||
*** | *** [[Stroke volume]] ≤25ml/m^2. | ||
*** | ***Right ventricular [[end-diastolic volume]] ≥84ml/m^2( Most appropriate marker of right ventricular failure in the follow-up.) | ||
*** | ***Left ventricvular [[end-diastolic volume]] ≤40ml/m^2 | ||
* | *Pulmonary artery stiffness measured by relative cross sectional area change ≤16% also has implications on mortality rate. | ||
===MRI Limitations include=== | ===MRI Limitations include=== | ||
Revision as of 17:49, 26 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Assistant Editor(s)-in-Chief: Ralph Matar
Overview
Cardiac MRI provides important prognostic indicators regarding the function of right ventricle in patients with pulmonary hypertension.
MRI
Role of MRI
The role of MRI:[1][2][3][4][5]
- Accurate evaluation of the size, morphology and function of the right ventricle.
- MRI has similar abilities to those of echocardiography in the diagnosis and treatment of patients with pulmonary hypertension.
- Detection of shunts contributing to pulmonary hypertension.
- Detection of acute and chronic pulmonary thromboembolic disease.
- Differentiation between the pulmonary vasculature and mediastinal adenopathy when used for contrast enhancement.
- Follow-up for right heart hemodynamics.
- Poor right ventricular function is indicated by the following according to the ACCF/AHA 2009 expert consensus document on pulmonary hypertension:
- Stroke volume ≤25ml/m^2.
- Right ventricular end-diastolic volume ≥84ml/m^2( Most appropriate marker of right ventricular failure in the follow-up.)
- Left ventricvular end-diastolic volume ≤40ml/m^2
- Poor right ventricular function is indicated by the following according to the ACCF/AHA 2009 expert consensus document on pulmonary hypertension:
- Pulmonary artery stiffness measured by relative cross sectional area change ≤16% also has implications on mortality rate.
MRI Limitations include
- Inability to perform breath hold
- Incompatible hardware such as neurostimulators, cochlear implants, aneurysm clips, cardiac pacemakers and defibrillators
- Limited availability and cost
- Difficulty in assessing PA pressures
References
- ↑ Alassas K, Mergo P, Ibrahim e, Burger C, Safford R, Parikh P, Shapiro B (January 2014). "Cardiac MRI as a diagnostic tool in pulmonary hypertension". Future Cardiol. 10 (1): 117–30. doi:10.2217/fca.13.97. PMID 24344668. Vancouver style error: initials (help)
- ↑ Lungu A, Wild JM, Capener D, Kiely DG, Swift AJ, Hose DR (September 2014). "MRI model-based non-invasive differential diagnosis in pulmonary hypertension". J Biomech. 47 (12): 2941–7. doi:10.1016/j.jbiomech.2014.07.024. PMID 25145313.
- ↑ Ohira H, Beanlands RS, Davies RA, Mielniczuk L (February 2015). "The role of nuclear imaging in pulmonary hypertension". J Nucl Cardiol. 22 (1): 141–57. doi:10.1007/s12350-014-9960-y. PMID 25161042.
- ↑ Kreitner KF, Wirth GM, Krummenauer F, Weber S, Pitton MB, Schneider J, Mayer E, Dueber C (September 2013). "Noninvasive assessment of pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension by high temporal resolution phase-contrast MRI: correlation with simultaneous invasive pressure recordings". Circ Cardiovasc Imaging. 6 (5): 722–9. doi:10.1161/CIRCIMAGING.112.000276. PMID 23863980.
- ↑ Wirth G, Brüggemann K, Bostel T, Mayer E, Düber C, Kreitner KF (August 2014). "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". Rofo. 186 (8): 751–61. doi:10.1055/s-0034-1366425. PMID 24756429.