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MR 4D flow-based mean pulmonary arterial pressure tracking in pulmonary hypertension
- Source :
- European Radiology
- Publication Year :
- 2020
- Publisher :
- Springer Berlin Heidelberg, 2020.
-
Abstract
- Objectives Longitudinal hemodynamic follow-up is important in the management of pulmonary hypertension (PH). This study aimed to evaluate the potential of MR 4-dimensional (4D) flow imaging to predict changes in the mean pulmonary arterial pressure (mPAP) during serial investigations. Methods Forty-four adult patients with PH or at risk of developing PH repeatedly underwent routine right heart catheterization (RHC) and near-term MR 4D flow imaging of the main pulmonary artery. The duration of vortical blood flow along the main pulmonary artery was evaluated from MR 4D velocity fields using prototype software and converted to an MR 4D flow imaging-based mPAP estimate (mPAPMR) by a previously established model. The relationship of differences between RHC-derived baseline and follow-up mPAP values (ΔmPAP) to corresponding differences in mPAPMR (ΔmPAPMR) was analyzed by means of regression and Bland-Altman analysis; the diagnostic performance of ΔmPAPMR in predicting mPAP increases or decreases was investigated by ROC analysis. Results Areas under the curve for the prediction of mPAP increases and decreases were 0.92 and 0.93, respectively. With the natural cutoff ΔmPAPMR = 0 mmHg, mPAP increases (decreases) were predicted with an accuracy, sensitivity, and specificity of 91% (91%), 85% (89%), and 94% (92%), respectively. For patients in whom 4D flow allowed a point estimate of mPAP (mPAP > 16 mmHg), ΔmPAPMR correlated strongly with ΔmPAP (r = 0.91) and estimated ΔmPAP bias-free with a standard deviation of 5.1 mmHg. Conclusions MR 4D flow imaging allows accurate non-invasive prediction and quantification of mPAP changes in adult patients with PH or at risk of developing PH. Trial registration ClinicalTrials.gov identifier: NCT00575692 and NCT01725763 Key Points • MR 4D flow imaging allows accurate non-invasive prediction of mean pulmonary arterial pressure increases and decreases in adult patients with or at risk of developing pulmonary hypertension. • In adult patients with mean pulmonary arterial pressure > 16 mmHg, MR 4D flow imaging allows estimation of longitudinal mean pulmonary arterial pressure changes without bias with a standard deviation of 5.1 mmHg.
- Subjects :
- Adult
medicine.medical_specialty
Cardiac Catheterization
Hypertension, Pulmonary
Hemodynamics
Follow-up studies
030204 cardiovascular system & hematology
Pulmonary Artery
Standard deviation
030218 nuclear medicine & medical imaging
Pulmonary hypertension
03 medical and health sciences
0302 clinical medicine
Magnetic resonance imaging
Internal medicine
Cutoff
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Arterial Pressure
Neuroradiology
medicine.diagnostic_test
business.industry
Ultrasound
General Medicine
Blood flow
medicine.disease
Cardiology
Radiology
business
Cardiac
Subjects
Details
- Language :
- English
- ISSN :
- 14321084 and 09387994
- Volume :
- 31
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- European Radiology
- Accession number :
- edsair.doi.dedup.....aa2965a352376fb555ecb97be9d0a47b