Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Published online before print February 28, 2007, 10.1148/radiol.2431060477
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
2431060477v1
243/1/70    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sanz, J.
Right arrow Articles by Poon, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sanz, J.
Right arrow Articles by Poon, M.
(Radiology 2007;243:70-79.)
© RSNA, 2007

Cardiac Imaging

Pulmonary Arterial Hypertension: Noninvasive Detection with Phase-Contrast MR Imaging1

Javier Sanz, MD, Paola Kuschnir, MD, Teresa Rius, MD, Rafael Salguero, MD, Roxana Sulica, MD, Andrew J. Einstein, MD, PhD, Santo Dellegrottaglie, MD, Valentin Fuster, MD, PhD, Sanjay Rajagopalan, MD and Michael Poon, MD

1 From the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, Box 1030, One Gustave L. Levy Place, New York, NY 10029 (J.S., P.K., R. Salguero, R. Sulica, A.J.E., S.D., V.F., S.R.); Department of Cardiology, Centro Médico Teknon, Barcelona, Spain (T.R.); and Department of Cardiology, Cabrini Medical Center, New York, NY (M.P.). Received March 15, 2006; revision requested May 18; revision received June 13; final version accepted August 9. Supported in part by the Mount Sinai School of Medicine Consortium for Cardiovascular Imaging Technology, New York, NY. J.S. supported by a research grant from the Spanish Society of Cardiology ("Beca para la Formación en Investigación Post-Residencia"). S.D. supported by a research grant from the Italian Society of Cardiology. Address correspondence to J.S. (email: Javier.Sanz@mssm.edu).

Purpose: To retrospectively identify pulmonary arterial (PA) flow parameters measured with phase-contrast magnetic resonance (MR) imaging that allow noninvasive diagnosis of chronic PA hypertension (PAH).

Materials and Methods: The study was HIPAA compliant and was approved by the institutional review board; a waiver of informed consent was obtained. Fifty-nine patients (49 female patients; mean age, 46 years; range, 16–85 years) known to have or suspected of having PAH underwent breath-hold phase-contrast MR imaging and right-sided heart catheterization (RHC). The presence of PAH (mean pulmonary artery pressure [mPAP], >25 mm Hg) was confirmed in 42 patients. Parameters, including PA areas, PA strain, average velocity, peak velocity, acceleration time, and ejection time, were measured in each patient by investigators blinded to RHC results. These measurements were correlated with mPAP, systolic pulmonary artery pressure (sPAP), and pulmonary vascular resistance index (PVRI). The diagnostic ability of phase-contrast MR imaging to depict PAH was quantified. Statistical tests included Spearman {rho} coefficients, receiver operating characteristic curve analysis, and Bland-Altman plots.

Results: Results showed average velocity to have the best correlation with mPAP, sPAP, and PVRI (r = –0.73, –0.76, and –0.86, respectively; P < .001). Average velocity (cutoff value = 11.7 cm/sec) revealed PAH with a sensitivity of 92.9% (39 of 42) and a specificity of 82.4% (14 of 17). Sensitivity and specificity for the minimum PA area (cutoff value = 6.6 cm2) were 92.9% (39 of 42) and 88.2% (15 of 17), respectively.

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

© RSNA, 2007




This article has been cited by other articles:


Home page
 J Am Coll Cardiol ImgHome page
J. Sanz, M. Kariisa, S. Dellegrottaglie, S. Prat-Gonzalez, M. J. Garcia, V. Fuster, and S. Rajagopalan
Evaluation of pulmonary artery stiffness in pulmonary hypertension with cardiac magnetic resonance.
J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 286 - 295.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. Benza, R. Biederman, S. Murali, and H. Gupta
Role of Cardiac Magnetic Resonance Imaging in the Management of Patients With Pulmonary Arterial Hypertension
J. Am. Coll. Cardiol., November 18, 2008; 52(21): 1683 - 1692.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
M. Miyazaki and V. S. Lee
Nonenhanced MR Angiography
Radiology, July 1, 2008; 248(1): 20 - 43.
[Abstract] [Full Text] [PDF]