Gisela M B Meyer1, Fernanda B Spilimbergo1, Stephan Altmayer2,3,4, Gabriel S Pacini5,6,7, Matheus Zanon2,3,4, Guilherme Watte8,4, Edson Marchiori9, Bruno Hochhegger2,3,4. 1. Pulmonary Hypertension Group, Santa Casa de Porto Alegre, Av. Independência, 75, Porto Alegre, Rio Grande Do Sul, 90020-160, Brazil. 2. Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil. 3. Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil. 4. LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil. 5. Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil. gabrielsartorip@gmail.com. 6. Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil. gabrielsartorip@gmail.com. 7. LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil. gabrielsartorip@gmail.com. 8. Department of Respiratory Medicine and Thoracic Surgery, Irmandade da Santa Casa de Misericordia de Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050-170, Brazil. 9. Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Rio De Janeiro, 21941-902, Brazil.
Abstract
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings. We performed correlations between the MRI-derived hemodynamic parameters and those from RHC. The sensitivity and specificity of MRI were determined to identify its diagnostic performance to identify chronic thromboembolic pulmonary hypertension (CTEPH) and interstitial lung disease PH. The gold standard reference for the diagnosis of CTEPH and ILD was based on a review of multimodality imaging (V/Q scintigraphy and CT scan) and clinical findings. RESULTS: Our results showed a good correlation between the hemodynamic parameters of cardiac MRI and RHC. Pulmonary vascular resistance had the best correlation between both methods (r = 0.923). The sensitivity and specificity of MRI to diagnose CTEPH was 100 and 96.8%, respectively. For the ILD-related PH, the MRI yielded a sensitivity of 60.0% and a specificity of 100%. Additionally, cardiac MRI was able to confirm all cases of PAH due to congenital heart disease initially detected by echocardiography. CONCLUSIONS: MRI represents a promising imaging modality as an initial, single-shot study, for patients with suspected PH with the advantages of being non-invasive and having no radiation exposure.
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings. We performed correlations between the MRI-derived hemodynamic parameters and those from RHC. The sensitivity and specificity of MRI were determined to identify its diagnostic performance to identify chronic thromboembolic pulmonary hypertension (CTEPH) and interstitial lung disease PH. The gold standard reference for the diagnosis of CTEPH and ILD was based on a review of multimodality imaging (V/Q scintigraphy and CT scan) and clinical findings. RESULTS: Our results showed a good correlation between the hemodynamic parameters of cardiac MRI and RHC. Pulmonary vascular resistance had the best correlation between both methods (r = 0.923). The sensitivity and specificity of MRI to diagnose CTEPH was 100 and 96.8%, respectively. For the ILD-related PH, the MRI yielded a sensitivity of 60.0% and a specificity of 100%. Additionally, cardiac MRI was able to confirm all cases of PAH due to congenital heart disease initially detected by echocardiography. CONCLUSIONS: MRI represents a promising imaging modality as an initial, single-shot study, for patients with suspected PH with the advantages of being non-invasive and having no radiation exposure.
Entities:
Keywords:
Computed tomography; Lung scintigraphy; Magnetic resonance imaging; Pulmonary hypertension; Right heath catheterization
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