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
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.