A non-invasive assessment of cardiopulmonary hemodynamics with MRI in pulmonary hypertension.
A non-invasive assessment of cardiopulmonary hemodynamics with MRI in pulmonary hypertension.
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DOI：
10.1016/j.mri.2015.08.005
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发表时间：
2015-12
影响因子：
2.5
通讯作者：
Carroll TJ
中科院分区：
文献类型：
--
作者：
Bane O;Shah SJ;Cuttica MJ;Collins JD;Selvaraj S;Chatterjee NR;Guetter C;Carr JC;Carroll TJ
我们提出了一种无创定量肺动脉高压（PH）引起的肺动脉血流动力学变化的方法。使用两元件Windkessel模型，以及从流量、心脏功能和瓣膜运动的标准MRI评价中导出的输入参数，我们导出：肺动脉顺应性（C）、平均肺动脉压（mPAP）、肺血管阻力（PVR）、肺毛细血管楔压（PCWP）、时间平均肺内压波形和肺动脉压（收缩压（sPAP）和舒张压（dPAP））。MRI结果直接与一系列疑似肺动脉高压（PH）患者的右心导管检查（RHC）的参考标准值进行比较。对7例可疑PH患者行RHC、MRI和超声心动图检查，MRI和RHC所测参数无显著性差异（p<0.05）。以mPAP ≥ 25 mmHg为标准临床临界值，MRI能正确诊断肺动脉高压，7例中5例能正确区分肺动脉高压（mPAP≥ 25 mmHg，PCWP<15 mmHg）和静脉高压（mPAP ≥ 25 mmHg，PCWP ≥ 15 mmHg）。我们已经开发了一种数学模型，能够量化反映PH严重程度的生理参数。
We propose a method for non-invasive quantification of hemodynamic changes in the pulmonary arteries resulting from pulmonary hypertension (PH). Using a two-element windkessel model, and input parameters derived from standard MRI evaluation of flow, cardiac function and valvular motion, we derive: pulmonary artery compliance (C), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), time-averaged intra-pulmonary pressure waveforms and pulmonary artery pressures (systolic (sPAP) and diastolic (dPAP)). MRI results were compared directly to reference standard values from right heart catheterization (RHC) obtained in a series of patients with suspected pulmonary hypertension (PH). In 7 patients with suspected PH undergoing RHC, MRI and echocardiography, there was no statistically significant difference (p<0.05) between parameters measured by MRI and RHC. Using standard clinical cutoffs to define PH (mPAP ≥ 25 mmHg), MRI was able to correctly identify all patients as having pulmonary hypertension, and to correctly distinguish between pulmonary arterial (mPAP≥ 25 mmHg, PCWP<15 mmHg) and venous hypertension (mPAP ≥ 25 mmHg, PCWP ≥ 15 mmHg) in 5 of 7 cases. We have developed a mathematical model capable of quantifying physiological parameters that reflect the severity of PH.