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Value of MR phase-contrast flow measurements for functional assessment of pulmonary arterial hypertension

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Abstract

Goals of our study were to compare the pulmonary hemodynamics between healthy volunteers and patients with pulmonary arterial hypertension (PAH) and correlate MR flow measurements with echocardiography. Twenty-five patients with PAH and 25 volunteers were examined at 1.5 T. Phase-contrast flow measurements were performed in the ascending aorta and pulmonary trunk, resulting in the following parameters: peak velocity (cm/s), average blood flow (l/min), time to peak velocity (ms), velocity rise gradient and pulmonary distensibility (cm2). The bronchosystemic shunt was calculated. In PAH patients transthoracic echocardiography and right-heart catheterization (RHC) served as the gold standard. In comparison to volunteers, the PAH patients showed significantly reduced pulmonary velocities (P = 0.002), blood flow (P = 0.002) and pulmonary distensibility (P = 0.008). In patients, the time to peak velocity was shorter (P<0.001), and the velocity rise gradient was steeper (P = 0.002) than in volunteers. While in volunteers the peak velocity in the aorta was reached earlier, it was the reverse in patients. Patients showed a significant bronchosystemic shunt (P = 0.01). No meaningful correlation was found between MRI measurements and echocardiography or RHC. MRI is a feasible technique for the differentiation between PAH and volunteers. Further studies have to be conducted for the absolute calculation of pressure estimates.

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Acknowledgement

The authors are very grateful to Mrs. Sandra Kreuscher and Nicola Ehlken for perfectly co-coordinating the patients’ appointments. MRI measurements were excellently performed by Susanne Yubai, RT, and Kathleen Knauer, RT.

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Authors and Affiliations

  1. Department of Radiology (E010), German Cancer Research Center DKFZ, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Sebastian Ley, Michael Puderbach, Helena Schöck, Monika Eichinger, Julia Ley-Zaporozhan, Christian Fink & Hans-Ulrich Kauczor

  2. Department of Pediatric Radiology, University Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg, Germany

    Sebastian Ley

  3. Department of Internal Medicine III, University Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Derliz Mereles & Ekkehard Gruenig

Authors
  1. Sebastian Ley
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  2. Derliz Mereles
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  3. Michael Puderbach
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  5. Helena Schöck
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  7. Julia Ley-Zaporozhan
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  8. Christian Fink
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  9. Hans-Ulrich Kauczor
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Correspondence to Sebastian Ley.

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Sebastian Ley and Derliz Mereles: Both authors contributed equally.

This work was supported by the DFG (FOR 474)

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Ley, S., Mereles, D., Puderbach, M. et al. Value of MR phase-contrast flow measurements for functional assessment of pulmonary arterial hypertension. Eur Radiol 17, 1892–1897 (2007). https://doi.org/10.1007/s00330-006-0559-9

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  • DOI: https://doi.org/10.1007/s00330-006-0559-9

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