4D flow cardiac MRI to assess pulmonary blood flow in patients with pulmonary arterial hypertension associated with congenital heart disease

IF 4.9 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Estibaliz Valdeolmillos , Hichem Sakhi , Marine Tortigue , Marion Audié , Marc-Antoine Isorni , Florence Lecerf , Olivier Sitbon , David Montani , Xavier Jais , Laurent Savale , Marc Humbert , Arshid Azarine , Sébastien Hascoët
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引用次数: 0

Abstract

Purpose

The purpose of this study was to evaluate the accuracy of four-dimensional flow cardiac magnetic resonance imaging (4D flow MRI) compared to right heart catheterization in measuring pulmonary flow (Qp), systemic flow (Qs) and pulmonary-to-systemic flow ratio (Qp/Qs) in patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD).

Materials and methods

The study was registered on Clinical-trial.gov (NCT03928002). Sixty-four patients with PAH-CHD who underwent 4D flow MRI were included. There were 16 men and 48 women with a mean age of 45.3 ± 13.7 (standard deviation [SD]) years (age range: 21–77 years). Fifty patients (50/64; 78%) presented with pre-tricuspid shunt. Qp (L/min), Qs (L/min) and Qp/Qs were measured invasively using direct Fick method during right heart catheterization and compared with measurements assessed by 4D flow MRI within a 24–48-hour window.

Results

The average mean pulmonary artery pressure was 51 ± 17 (SD) mm Hg with median pulmonary vascular resistance of 8.8 Wood units (Q1, Q3: 5.3, 11.7). A strong linear correlation was found between Qp measurements obtained with 4D flow MRI and those obtained with the Fick method (r = 0.96; P < 0.001). Bland Altman analysis indicated a mean difference of 0.15 ± 0.48 (SD) L/min between Qp estimated by 4D flow MRI and by right heart catheterization. A strong correlation was found between Qs and Qp/Qs measured by 4D flow MRI and those obtained with the direct Fick method (r = 0.85 and r = 0.92; P < 0.001 for both).

Conclusion

Qp as measured by 4D flow MRI shows a strong correlation with measurements derived from the direct Fick method. Further investigation is needed to develop less complex and standardized methods for measuring essential PAH parameters, such as pulmonary arterial pressures and pulmonary vascular resistance.

4D 流式心脏磁共振成像评估先天性心脏病肺动脉高压患者的肺血流。
目的:本研究旨在评估四维血流心脏磁共振成像(4D flow MRI)与右心导管检查相比,在测量肺动脉高压伴先天性心脏病(PAH-CHD)患者的肺血流(Qp)、全身血流(Qs)和肺-全身血流比(Qp/Qs)方面的准确性:该研究已在 Clinical-trial.gov (NCT03928002) 上注册。研究纳入了 64 名接受 4D 血流 MRI 检查的 PAH-CHD 患者。其中男性 16 人,女性 48 人,平均年龄为 45.3 ± 13.7(标准差 [SD])岁(年龄范围:21-77 岁)。50名患者(50/64;78%)出现三尖瓣前分流。在右心导管检查过程中采用直接费克法对 Qp(升/分)、Qs(升/分)和 Qp/Qs 进行了有创测量,并与 24-48 小时内通过四维血流磁共振成像评估的测量结果进行了比较:平均肺动脉压为 51 ± 17 (SD) mm Hg,中位肺血管阻力为 8.8 Wood 单位(Q1, Q3: 5.3, 11.7)。四维血流磁共振成像获得的 Qp 测量值与菲克法获得的 Qp 测量值之间存在很强的线性相关(r = 0.96;P < 0.001)。Bland Altman 分析表明,四维血流磁共振成像和右心导管检查估测的 Qp 平均相差 0.15 ± 0.48 (SD) 升/分钟。四维血流磁共振成像测量的 Qs 和 Qp/Qs 与直接 Fick 法测量的 Qs 和 Qp/Qs 之间存在很强的相关性(r = 0.85 和 r = 0.92;两者的 P < 0.001):结论:四维血流磁共振成像测得的 Qp 与直接菲克法测得的结果有很强的相关性。需要进一步研究,开发出不那么复杂且标准化的方法来测量 PAH 重要参数,如肺动脉压和肺血管阻力。
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来源期刊
Diagnostic and Interventional Imaging
Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
8.50
自引率
29.10%
发文量
126
审稿时长
11 days
期刊介绍: Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.
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