Black blood MRI has diagnostic and prognostic value in the assessment of patients with pulmonary hypertension
Black blood MRI has diagnostic and prognostic value in the assessment of patients with pulmonary hypertension
复制标题
DOI：
10.1007/s00330-011-2306-0
复制
发表时间：
2012-03-01
影响因子：
5.9
通讯作者：
Kiely, David G.
中科院分区：
文献类型：
--
作者：
Swift, Andrew J.;Rajaram, Smitha;Kiely, David G.
目的双反转恢复（Double Inversion Recovery，简称DIF）“黑血”MRI抑制了血流信号，血流缓慢导致抑制不完全，造成肺血流伪影（PFA）。方法回顾性分析233例在MR检查后48 h内行右心导管术（RHC）的可疑肺动脉高压（PH）患者的DIR-MRI图像，对PFA评分0 ~ 5分，并对评分结果进行统计学分析（0 =缺失，1 =节段性，2 =肺叶，3 =远端主干，4 =近端主干和5 =主干）。测量肺动脉（PA）、主动脉（Ao）和PA主要分支直径，计算PA/Ao比值和PA平均分支直径（MPAB）。PFA与血流动力学参数PVR（r = 0.70）、mPAP（r = 0.65）和CI（r = -0.53）有良好的相关性。PFA预测平均随访19个月期间的死亡率（P = 0.005）。PFA评分显示了良好的观察者间一致性（k = 0.83）。PFA评分在评估疑似PH患者中具有诊断和预后价值，并且是死亡率的预测因子。
Objectives Double inversion recovery (DIR) "black blood" MRI suppresses the signal from flowing blood, slow flowing blood causes incomplete suppression resulting in pulmonary blood flow artefact (PFA). This study examines the diagnostic utility and prognostic value of a PFA scoring system in a mixed cohort of patients with pulmonary hypertension (PH).Methods DIR-MRI images were reviewed for 233 patients referred with suspected PH who underwent right heart catheterisation (RHC) within 48 h of MR. The degree of PFA was visually scored in all patients from 0 to 5 (0 = absent, 1 = segmental, 2 = lobar, 3 = distal main, 4 = proximal main and 5 = trunk). Pulmonary artery (PA), aorta (Ao), and PA main branch diameters were measured from which PA/Ao ratios and mean PA branch diameters (MPAB) were calculated.PFA > 1 demonstrated high sensitivity (86%) and specificity (85%) for the diagnosis PH in our mixed patient cohort. A good correlation was found with PFA and haemodynamic parameters, PVR (r = 0.70), mPAP (r = 0.65) and CI (r = -0.53). PFA predicted mortality (P = 0.005) during the mean follow-up for 19 months. PFA scoring demonstrated good inter-observer agreement (k = 0.83).PFA scoring is of diagnostic and prognostic value in the assessment of patients with suspected PH. and is a predictor of mortality.