MR 4D flow-based mean pulmonary arterial pressure tracking in pulmonary hypertension

Ursula Reiter*, Gabor Kovacs, Clemens Reiter, Corina Kräuter, Volha Nizhnikava, Michael Fuchsjäger, Horst Olschewski, Gert Reiter

*Korrespondierende/r Autor/in für diese Arbeit

Publikation: Beitrag in einer FachzeitschriftArtikel

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.

Originalspracheenglisch
Seiten (von - bis)1883-1893
Seitenumfang11
FachzeitschriftEuropean Radiology
Jahrgang31
Ausgabenummer4
Frühes Online-Datum24 Sep 2020
DOIs
PublikationsstatusVeröffentlicht - Apr 2021

ASJC Scopus subject areas

  • !!Radiology Nuclear Medicine and imaging

Fingerprint

Untersuchen Sie die Forschungsthemen von „MR 4D flow-based mean pulmonary arterial pressure tracking in pulmonary hypertension“. Zusammen bilden sie einen einzigartigen Fingerprint.

Dieses zitieren