Cardiovascular magnetic resonance for the assessment of pulmonary arterial hypertension: toward a comprehensive CMR exam
Cardiovascular magnetic resonance for the assessment of pulmonary arterial hypertension: toward a comprehensive CMR exam
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DOI：
10.1016/j.mri.2012.03.001
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发表时间：
2012-10-01
影响因子：
2.5
通讯作者：
White, Richard D.
中科院分区：
文献类型：
--
作者：
Ibrahim, El-Sayed H.;White, Richard D.
肺动脉高压（PAH）是一种以肺循环血压异常升高为特征的进行性疾病。未经治疗的PAH的临床过程包括迅速发展为右心室（RV）衰竭和死亡。右心导管是确认多环芳烃的金标准方法。然而，该技术的侵入性和相关风险使其无法定期使用。不同的成像技术已用于评估多环芳烃，包括超声心动图，计算机断层扫描和核医学。然而，这些技术有其自身的局限性。在过去的十年中，心血管磁共振（CMR）越来越多地用于评估不同的心血管疾病，包括多环芳烃，因为它具有高分辨率，高组织对比度，以及可以用这种方式测量的大量解剖和生理参数。本文介绍了用于评估PAH的CMR实施的最新综述。这是通过描述一个全面的CMR方案来实现的，该方案包括用于评估与PAH相关的不同心血管参数的几个成像序列。与之前发表的文章相比，本研究的CMR方案评估了PAH患者的右心室功能和肺动脉血流动力学，这两者都受到了影响。每个成像序列都解释了所需的图像分析步骤，以获得感兴趣的心血管参数。然后，在大量文献综述的基础上，本文阐述了衍生心血管参数的意义及其与多环芳烃的关系。文章最后讨论了拟议的CMR检查的优势，以便更好地了解疾病的病理生理和治疗计划。(C) 2012爱思唯尔公司版权所有。
Pulmonary arterial hypertension (PAH) is a progressive disorder characterized by abnormally increased blood pressure of the pulmonary circulation. The clinical course of the untreated PAH involves rapid progression to right ventricular (RV) failure and death. Right heart catheterization is the gold-standard method for confirming PAH. However, the technique's invasiveness and associated risks preclude its use on a regular basis. Different imaging techniques have been implemented for evaluating PAH, including echocardiography, computed tomography and nuclear medicine. However, these techniques have their own limitations. During the past decade, cardiovascular magnetic resonance (CMR) has been increasingly used for the evaluation of different cardiovascular diseases, including PAH, due to its high resolution, high tissue contrast, and the plethora of anatomical and physiological parameters that can be measured with this modality. This article presents an up-to-date review of the implementation of CMR for evaluating PAH. This is achieved by describing a comprehensive CMR protocol that includes several imaging sequences for assessing different cardiovascular parameters pertaining to PAH. In contrast to the previously published articles, the presented CMR protocol evaluates both RV function and pulmonary artery hemodynamics, which are both affected in PAH. Each imaging sequence is explained along with the image analysis steps required for deriving the cardiovascular parameters of interest. Then, based on an extensive literature review, the article illustrates the significance of the derived cardiovascular parameters and their association with PAH. The article concludes with a discussion of the advantages of the proposed CMR exam for better understanding of the disease pathophysiology and treatment planning. (C) 2012 Elsevier Inc. All rights reserved.