OBJECTIVES: To validate in vivo a magnetic resonance imaging (MRI) method for measurement of pulmonary vascular resistance (PVR) and subsequently to apply this technique to patients with pulmonary hypertension (PHT). METHODS AND RESULTS: PVR was assessed from velocity encoded cine MRI derived pulmonary artery (PA) flow volumes and simultaneously determined invasive PA pressures. For pressure measurements flow directed catheters were guided under magnetic resonance fluoroscopy at 1.5 T into the PA. In preliminary validation studies (eight swine) PVR was determined with the thermodilution technique and compared with PVR obtained by MRI (0.9 (0.5) v 1.1 (0.3) Wood units.m2, p = 0.7). Bland-Altman test showed agreement between both methods. Inter-examination variability was high for thermodilution (6.2 (2.2)%) but low for MRI measurements (2.1 (0.3)%). After validation, the MRI method was applied in 10 patients with PHT and five controls. In patients with PHT PVR was measured at baseline and during inhalation of nitric oxide. Compared with the control group, PVR was significantly increased in the PHT group (1.2 (0.8) v 13.1 (5.6) Wood units.m2, p < 0.001) but decreased significantly to 10.3 (4.6) Wood units.m2 during inhalation of nitric oxide (p < 0.05). Inter-examination variability of MRI derived PVR measurements was 2.6 (0.6)%. In all experiments (in vivo and clinical) flow directed catheters were guided successfully into the PA under MRI control. CONCLUSIONS: Guidance of flow directed catheters into the PA is feasible under MRI control. PVR can be determined with high measurement precision with the proposed MRI technique, which is a promising tool to assess PVR in the clinical setting.
OBJECTIVES: To validate in vivo a magnetic resonance imaging (MRI) method for measurement of pulmonary vascular resistance (PVR) and subsequently to apply this technique to patients with pulmonary hypertension (PHT). METHODS AND RESULTS:PVR was assessed from velocity encoded cine MRI derived pulmonary artery (PA) flow volumes and simultaneously determined invasive PA pressures. For pressure measurements flow directed catheters were guided under magnetic resonance fluoroscopy at 1.5 T into the PA. In preliminary validation studies (eight swine) PVR was determined with the thermodilution technique and compared with PVR obtained by MRI (0.9 (0.5) v 1.1 (0.3) Wood units.m2, p = 0.7). Bland-Altman test showed agreement between both methods. Inter-examination variability was high for thermodilution (6.2 (2.2)%) but low for MRI measurements (2.1 (0.3)%). After validation, the MRI method was applied in 10 patients with PHT and five controls. In patients with PHT PVR was measured at baseline and during inhalation of nitric oxide. Compared with the control group, PVR was significantly increased in the PHT group (1.2 (0.8) v 13.1 (5.6) Wood units.m2, p < 0.001) but decreased significantly to 10.3 (4.6) Wood units.m2 during inhalation of nitric oxide (p < 0.05). Inter-examination variability of MRI derived PVR measurements was 2.6 (0.6)%. In all experiments (in vivo and clinical) flow directed catheters were guided successfully into the PA under MRI control. CONCLUSIONS: Guidance of flow directed catheters into the PA is feasible under MRI control. PVR can be determined with high measurement precision with the proposed MRI technique, which is a promising tool to assess PVR in the clinical setting.
Authors: Marc E Miquel; Sanjeet Hegde; Vivek Muthurangu; Benjamin J Corcoran; Stephen F Keevil; Derek L G Hill; Reza S Razavi Journal: Magn Reson Med Date: 2004-05 Impact factor: 4.668
Authors: Simon Schalla; Maythem Saeed; Charles B Higgins; Alastair Martin; Oliver Weber; Phillip Moore Journal: Circulation Date: 2003-09-29 Impact factor: 29.690
Authors: Philipp Beerbaum; Hermann Körperich; Jürgen Gieseke; Peter Barth; Matthias Peuster; Hans Meyer Journal: Circulation Date: 2003-08-25 Impact factor: 29.690
Authors: Titus Kuehne; Maythem Saeed; Charles B Higgins; Kelly Gleason; Gabriele A Krombach; Oliver M Weber; Alastair J Martin; Daniel Turner; David Teitel; Phillip Moore Journal: Radiology Date: 2003-02 Impact factor: 11.105
Authors: Vivek Muthurangu; Andrew Taylor; Rado Andriantsimiavona; Sanjeet Hegde; Marc E Miquel; Robert Tulloh; Edward Baker; Derek L G Hill; Reza S Razavi Journal: Circulation Date: 2004-08-09 Impact factor: 29.690
Authors: Prasheel Lillaney; Curtis Caton; Alastair J Martin; Aaron D Losey; Leland Evans; Maythem Saeed; Daniel L Cooke; Mark W Wilson; Steven W Hetts Journal: Med Phys Date: 2014-02 Impact factor: 4.071
Authors: Jonathan R Mazal; Toby Rogers; William H Schenke; Anthony Z Faranesh; Michael Hansen; Kendall O'Brien; Kanishka Ratnayaka; Robert J Lederman Journal: Radiol Technol Date: 2016 Jan-Feb
Authors: Jeff L Zhang; Henry Rusinek; Louisa Bokacheva; Qun Chen; Pippa Storey; Vivian S Lee Journal: J Magn Reson Imaging Date: 2009-09 Impact factor: 4.813