Estimation of pulmonary hypertension by measurement of flow profile of pulmonary artery with CineMRI

本文应用相位对比MRI测量了20名志愿者的肺血流，并对垂直于肺动脉干和不垂直于肺动脉干两种切片位置的测量精度和可重复性进行了评价。我们检查了肺动脉血流和其他数据在评估肺动脉高压中是否有用。受试者为10名肺纤维化患者（他们被认为肺动脉压升高）和10名健康人。测量肺动脉血流，计算肺动脉高压的指标：加速时间（AT）、加速容积（AV）、M/AV（M：射血期间最大流速变化）、扩张性（Dis）、平均流量（Aveflo），并与健康人和肺纤维化患者进行比较。对患者进行呼吸功能检查，并评价其与各项指标的相关性。几乎所有指标在患者和志愿者之间都有显著差异。ROC分析表明，高能力的指标区分患者和健康志愿者。这些结果表明，相位对比MRI是一种有用的技术来评估肺动脉压的升高。与呼吸功能检查结果比较，Dis、Aveflo与肺纤维化严重程度有较好的相关性。提示这些指标反映了肺远端的变化，即肺动脉高压。e.纤维化，优于肺动脉压。需要进一步的调查来证实这些结果

We measured pulmonary blood flow with phase contrast MRI for 20 volunteers and evaluated precision and reproducible of two slice positions, that is, perpendicular to pulmonary trunck and not, We detected a method to determine the slice which was perpendicular to a pulmonary artery, and reported that precision and reproducibility is higher with perpendicular slicesBased on this preliminary study, we examined whether pulmonary artery blood flow and other data were useful in an evaluation of the pulmonary hypertension. The subjects were ten patients with pulmonary fibrosis (they were thought that pulmonary arterial pressure was elevated) and ten healthy people. We measured pulmonary artery blood flow and calculated an index of some pulmonary hypertension; acceleration time (AT), acceleration volumes (AV), ratios M to AV (M: maximal change in flow rate during ejection), distensibility (Dis), average flow (Aveflo) and compared healty persons and the patient with pulmonary fibrosis. Respiratory function test was performed to the patients and evaluated the correlation with the indices. Almost all indices were significantly different between patients and volunteers. ROC analysis showed high capability of indices to discriminate patients from healthy volunteers. These results show that phase contrast MRI is a useful technique to evaluate elevation of the pulmonary arterial pressure. Compared indices with respiratory function test results, Dis, Aveflo showed a good correlation with severity of the pulmonary fibrosis. This suggests that these indexes reflected the distal pulmonary change, i. e. fibrosis, better than pulmonary arterial pressure. Additional investigations are necessary to confirm these results