Pulmonary hypertension MRI

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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

  • 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 with 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:
  • 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
  • Limited availability and cost
  • Difficulty in assessing PA pressures

References

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