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01-06-2006 | Chest

MR imaging of the pulmonary vasculature—an update

Authors: Mark R. Pedersen, Mark T. Fisher, Edwin J. R. van Beek

Published in: European Radiology | Issue 6/2006

Abstract

Although the advent of multi-detector row computed tomography (CT) angiography has been at the heart of improving the diagnostic management of pulmonary vascular disease, MR technology has also moved forward. This review outlines the current state of affairs of MR techniques for the assessment of pulmonary vascular diseases such as pulmonary hypertension, pulmonary arteritis and arteriovenous malformations. It highlights the main areas of MR angiography and MR perfusion imaging and discusses novel methods, such as non-contrast enhanced direct thrombus imaging, and will discuss its merits in the context of other diagnostic modalities.

van Beek EJR, ten Cate JW (1996) The diagnosis of venous thromboembolism: an overview. In: Hull RD, Raskob GE, Pineo GF (eds) Venous thromboembolism: an evidence-based atlas. Futura, Armonk, pp 93–99

ESC Task Force on Pulmonary Embolism (2000) Guidelines on management of acute pulmonary embolism. Eur Heart J 21:1301–1336CrossRef

Simonneau G, Galie N, Rubin LJ, et al (2004) Clinical classification of pulmonary hypertension. J Am Coll Cardiol 43:5S–12SCrossRefPubMed

Burns A (1998) Pulmonary vasculitis. Thorax 53:220–227PubMedCrossRef

Itazawa T, Noguchi K, Ichida F, Miyawaki T (2001) Magnetic resonance imaging for early detection of Takayasu arteritis. Pediatr Cardiol 22:163–164CrossRefPubMed

Maki DD, Siegelman ES, Roberts DA, Baum RA, Gefter WB (2001) Pulmonary arteriovenous malformations: three-dimensional gadolinium enhanced MR angiography—initial experience. Radiology 219:243–246PubMed

Dill T, Neumann T, Ekinci O, et al (2003) Pulmonary vein diameter reduction after radiofrequency catheter ablation for paroxysmal atrial fibrillation evaluated by contrast-enhanced three-dimensional magnetic resonance imaging. Circulation 107:845–850CrossRefPubMed

Kluge A, Dill T, Ekinci O, et al (2004) Decreased pulmonary perfusion in pulmonary vein stenosis after radiofrequency ablation: assessment with dynamic magnetic resonance perfusion imaging. Chest 126:428–437CrossRefPubMed

Schoepf UJ, Costello P (2004) CT angiography for diagnosis of pulmonary embolism—state of the art. Radiology 230:329–337PubMedCrossRef

10.

Remy J, Remy-Jardin M, Giraud F, Wattinne L (1994) Angioarchitecture of pulmonary arteriovenous malformations: clinical utility of three-dimensional helical CT. Radiology 191:657–664PubMed

11.

Haramati LB, Moche I, Rivera VT, et al (2003) Computed tomography of partial anomalous pulmonary venous connection in adults. J Comput Assist Tomogr 27:743–749CrossRefPubMed

12.

Aluquin VPR, Albano SA, Chan F, Sandborg C, Pitlick PT (2002) Magnetic resonance imaging in the diagnosis and follow up of Takayasu’s arteritis in children. Ann Rheum Dis 61:526–529CrossRefPubMed

13.

Leung D, McKinnon G, Davis C, Pfammatter T, Krestin G, Debatin J (1996) Breath-hold, contrast-enhanced, three-dimensional MR angiography. Radiology 201:569–571PubMed

14.

Goyen M, Laub G, Ladd ME, et al (2001) Dynamic 3D MR angiography of the pulmonary arteries in under four seconds. J Magn Reson Imaging 13:372–377CrossRefPubMed

15.

Fujii M, Ohno Y, Kawamitsu H, et al (2002) Multiphase 3D contrast enhanced MRA of the lung using SENSE. In: Proceedings of the 10th Annual Meeting of ISMRM, Honolulu, p 1780

16.

Nikolaou K, Schoenberg SO, Nittka M, et al (2002) Magnetic resonance imaging in the diagnosis of pulmonary arterial hypertension: high resolution angiography and fast perfusion imaging using intelligent parallel acquisition techniques (iPAT). Radiology 225:473

17.

Loubeyre P, Revel D, Douek P, et al (1994) Dynamic contrast enhanced MR angiography of pulmonary embolism: comparison with pulmonary angiography. AJR Am J Roentgenol 162:1035–1039PubMed

18.

Nikolaou K, Schoenberg SO, Attenberger U, et al (2005) Pulmonary arterial hypertension: diagnosis with fast perfusion MR imaging and high-spatial-resolution MR angiography—preliminary experience. Radiology 235:694–703CrossRef

19.

Steiner P, McKinnon GC, Romanowski B, Goehde SC, Hany T, Debatin JF (1997) Contrast-enhanced, ultrafast 3D pulmonary MR angiography in a single breath hold: initial assessment of imaging performance. J Magn Reson Imaging 7:177–182PubMedCrossRef

20.

Meaney JF, Weg JG, Chenevert TL, Stafford-Johnson D, Hamilton BH, Prince MR (1997) Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med 336:1422–1427CrossRefPubMed

21.

Gupta A, Frazer CK, Ferguon JM, et al (1999) Acute pulmonary embolism: diagnosis with MR angiography. Radiology 210:353–359PubMed

22.

Oudkerk M, van Beek EJ, Wielopolski P, et al (2002) Comparison of contrast-enhanced magnetic resonance angiography and conventional pulmonary angiography for the diagnosis of pulmonary embolism: a prospective study. Lancet 359:1643–1647CrossRefPubMed

23.

Ohno Y, Higashino T, Takenaka D, et al (2004) MR angiography with sensitivity encoding (SENSE) for suspected pulmonary embolism: comparison with MDCT and ventilation–perfusion scintigraphy. AJR Am J Roentgenol 183:91–98PubMed

24.

Ley S, Kauczor H, Heussel C, Kramm T, Mayer E, Thelen M, Kreitner K (2003) Value of contrast-enhanced MR angiography and helical CT angiography in chronic thromboembolic pulmonary hypertension. Eur Radiol 13:2365–2371CrossRefPubMed

25.

Yeh EN, Stuber M, McKenzie CA, et al (2005) Inherently self-calibrating non-Cartesion parallel imaging. Magn Reson Med 54:1–8CrossRefPubMed

26.

Wielopolski P, Haacke E, Adler L (1993) Evaluation of the pulmonary vasculature with three-dimensional magnetic resonance imaging techniques. MAGMA 1:21–34CrossRef

27.

Schoenberg SO, Essig M, Bock M, Hawighorst H, Sharafuddin M, Knopp MV (1999) Comprehensive MR evaluation of renovascular disease in five breath holds. J Magn Reson Imaging 10:347–356CrossRefPubMed

28.

Sodickson DK, Manning WJ (1997) Simultaneous acquisition of spatial harmonics (SMASH): fast imaging with radiofrequency coil arrays. Magn Reson Med 38:591–603PubMedCrossRef

29.

Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P (1999) SENSE: sensitivity encoding for fast MRI. Magn Reson Med 42:952–962CrossRefPubMed

30.

Weiger M, Pruessmann KP, Kassner A, et al (2000) Contrast-enhanced 3D MRA using SENSE. J Magn Reson Imaging 12:671–677CrossRefPubMed

31.

Kelly J, Hunt BJ, Moody A (2003) Magnetic resonance direct thrombus imaging: a novel technique for imaging venous thromboemboli. Thromb Haemost 89:773–782PubMed

32.

Fraser DG, Moody AR, Morgan PS, Martel AL, Davidson I (2002) Diagnosis of lower-limb deep venous thrombosis: a prospective blinded study of magnetic resonance direct thrombus imaging. Ann Intern Med 136:89–98PubMed

33.

Hatabu H, Gaa J, Kim D, Li W, Prasad PV, Edelman RR (1996) Pulmonary perfusion: qualitative assessment with dynamic contrast enhanced MRI using ultra-short TE and inversion recovery turbo FLASH. Magn Reson Med 36:503–508PubMedCrossRef

34.

Amundsen T, Torheim G, Waage A, Bjermer L, Steen PA, Haraldseth O (2000) Perfusion magnetic resonance imaging of the lung: characterization of pneumonia and chronic obstructive pulmonary disease. A feasibility study. J Magn Reson Imaging 12:224–231CrossRefPubMed

35.

Ohno Y, Hatabu H, Takenaka D, Adachi S, Kono M, Sugimura K (2002) Solitary pulmonary nodules: potential role of dynamic MR imaging in management—initial experience. Radiology 224:503–511PubMedCrossRef

36.

Fink C, Bock M, Puderbach M, Schmahl A, Delorme S (2003) Partially parallel three-dimensional magnetic resonance imaging for the assessment of lung perfusion-initial results. Invest Radiol 38:482–488CrossRefPubMed

37.

Ohno Y, Kawamisu H, Higashino T, et al (2003) Time-resolved contrast-enhanced pulmonary MR angiography using sensitivity encoding (SENSE). J Magn Reson Imaging 17:330–336CrossRefPubMed

38.

Hatabu H, Tadamura E, Levin DL, et al (1999) Quantitative assessment of pulmonary perfusion with dynamic contrast-enhanced MRI. Magn Reson Med 42:1033–1038CrossRefPubMed

39.

Berthezene Y, Vexler V, Price DC, et al (1992) Magnetic resonance imaging detection of an experimental pulmonary perfusion deficit using a macromolecular contrast agent: polylysine-gadolinium-DTPA40. Invest Radiol 27:346–351PubMedCrossRef

40.

Nakagawa R, Sakuma H, Murashima S, Ishida N, Matsumura K, Takeda K (2001) Pulmonary ventilation–perfusion MR imaging in clinical patients. J Magn Reson Imaging 14:419–424CrossRefPubMed

41.

Iwasawa T, Saito K, Ogawa N, Ishiwa N, Kurihara H (2002) Prediction of postoperative pulmonary function using perfusion magnetic resonance imaging of the lung. J Magn Reson Imaging 16:685–692CrossRefPubMed

42.

Matsuoka S, Uchiyama K, Shima H, et al (2001) Detectability of pulmonary perfusion defect and influence of breath holding on contrast enhanced thick-slice 2D and on 3D MR pulmonary perfusion images. J Magn Reson Imaging 14:580–585CrossRefPubMed

43.

Kluge A, Gerriets T, Lange U, Bachman G (2005) MRI for short-term follow-up of acute pulmonary embolism. Assessment of thrombus appearance and pulmonary perfusion: a feasibility study. Eur Radiol 15:1969–1977CrossRefPubMed

44.

Fratz S, Hess J, Schwaiger M, Martinoff S, Stern HC (2002) More accurate quantification of pulmonary blood flow by magnetic resonance imaging than by lung perfusion scintigraphy in patients with fontan circulation. Circulation 106:1510–1513CrossRefPubMed

45.

Levin DL, Chen Q, Zhang M, Edelman RR, Hatabu H (2001) Evaluation of regional pulmonary perfusion using ultrafast magnetic resonance imaging. Magn Reson Med 46:166–171CrossRefPubMed

46.

Fink C, Puderbach M, Ley S, Zaporozhan J, Plathow C, Kauczor HU (2005) Time-resolved echo-shared parallel MRA of the lung: observer preference study of image quality in comparison with non-echo-shared sequences. Eur Radiol 15:2070–2074CrossRefPubMed

47.

Roberts DA, Gefter WB, Hirsch JA, et al (1999) Pulmonary perfusion: respiratory-triggered three-dimensional MR imaging with arterial spin tagging—preliminary results in healthy volunteers. Radiology 212:890–895PubMed

48.

Detre JA, Leigh JS, Williams DS, Koretsky AP (1992) Perfusion imaging. Magn Reson Med 23:37–45PubMedCrossRef

49.

Edelman RR, Hatabu H, Tadamura E, Kim D, Prasad PV, Buxton RB (1996) Pulmonary perfusion: non-invasive imaging and quantification by magnetic resonance. In: Proceedings of the 4th annual scientific meeting of the ISMRM, New York, p 1314

50.

Kwong KK, Belliveau JW, Chesler DA, et al (1992) Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proc Natl Acad Sci U S A 89:5675–5679PubMedCrossRef

51.

Kim SG (1995) Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping. Magn Reson Med 34:293–301PubMedCrossRef

52.

Mai VM, Berr SS (1999) MR perfusion imaging of pulmonary parenchyma using pulsed arterial spin labeling techniques: FAIRER and FAIR. J Magn Reson Imaging 9:483–487CrossRefPubMed

53.

Mai VM, Hagspiel KD, Christopher JM, Do HM, Altes T, Knight-Scott J, Stith AL, Maier T, Berr SS (1999) Perfusion imaging of the lung using flow-sensitive alternating inversion recovery with an extra radio-frequency pulse (FAIRER). Magn Reson Imaging 17:355–361CrossRefPubMed

54.

Balzer JO, Loewe C, Davis K, Goyen M, Leiner T, Meaney JF, Pockler-Schoniger C, Schulte-Altedorneburg G, Tombach B, Vosshenrich R, Wegener R (2003) Safety of contrast-enhanced MR angiography employing gadobutrol 1.0 M as contrast material. Eur Radiol 13:2067–2074CrossRefPubMed

55.

Tombach B, Bremer C, Reimer P, et al (2002) Using highly concentrated gadobutrol as an MR contrast agent in patients also requiring hemodialysis: safety and dialysability. AJR Am J Roentgenol 178:105–109PubMed

56.

Fink C, Puderbach M, Ley S, Plathow C, Bock M, Zuna I, Kauczor HU (2004) Contrast-enhanced three-dimensional pulmonary perfusion magnetic resonance imaging: intraindividual comparison of 1.0 M gadobutrol and 0.5 M Gd-DTPA at three dose levels. Invest Radiol 39:143–148CrossRefPubMed

57.

Fink C, Ley S, Plathow C, Kauczor HU (2002) Gadolinium containing contrast agents for pulmonary ventilation magnetic resonance imaging: preliminary results. Invest Radiol 37:120–125CrossRefPubMed

58.

Abolmaali ND, Hietschold V, Appold S, Ebert W, Vogl TJ (2002) Gadomer-17-enhanced 3D navigator-echo MR angiography of the pulmonary arteries in pigs. Eur Radiol 12:692–697PubMed

59.

Zheng J, Carr J, Harris K, et al (2001) Three-dimensional MR pulmonary perfusion imaging and angiography with an injection of a new blood pool contrast agent B-22956/1. J Magn Reson Imaging 14:425–432CrossRefPubMed

60.

Nitz WR (2002) Fast and ultrafast non-echo-planar MR imaging techniques. Eur Radiol 12:2866–2882PubMed

61.

Sodickson DK, McKenzie CA, Ohliger MA, Yeh EN, Price MD (2002) Recent advances in image reconstruction, coil sensitivity calibration, and coil array design for SMASH and generalized parallel MRI. MAGMA 13:158–163PubMedCrossRef

62.

Kluge A, Muller C, Hansel J, Gerriets T, Bachmann G (2004) Real-time MR with TrueFISP for the detection of acute pulmonary embolism: initial clinical experience. Eur Radiol 14:709–718CrossRefPubMed

63.

Kreitner KF, Ley S, Kauczor HU, et al (2004) Chronic thromboembolic pulmonary hypertension: pre- and postoperative assessment with breath-hold MR Imaging techniques. Radiology 232: 535–543PubMedCrossRef

64.

Roeleveld RJ Marcus JT, Boonstra A, et al (2005) A comparison of noninvasive MRI-based methods of estimating pulmonary artery pressure in pulmonary hypertension. J Magn Reson Imaging 22:67–72CrossRefPubMed

65.

Kato R, Lickfett L, Meininger G, et al (2003) Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. Circulation 107:2004–2010CrossRefPubMed

66.

Syed MA, Peters DC, Rashid H, Arai AE (2005) Pulmonary vein imaging: comparison of 3D magnetic resonance angiography with 2D cine MRI for characterizing anatomy and size. J Cardiovasc Magn Reson 7:355–360CrossRefPubMed

67.

Ohno Y, Hatabu H, Takenaka D, Adachi S, Hirota S, Sugimura K (2002) Contrast-enhanced MR perfusion imaging and MR angiography: utility for management of pulmonary arteriovenous malformations for embolotherapy. Eur J Radiol 41:136–146CrossRefPubMed

68.

Yamada I, Nakagawa T, Himeno Y, Kobayashi Y, Numano F, Shibuya H (2000) Takayasu arteritis: diagnosis with breath-hold contrast-enhanced three-dimensional MR angiography. J Magn Reson Imaging 11:481–487CrossRefPubMed

69.

Kauczor HU, Kreitner KF (2000) Contrast-enhanced MRI of the lung. Eur J Radiol 34:196–207CrossRefPubMed

70.

Alsop DC, Hatabu H, Bonnet M, Listerud J, Gefter W (1995) Multi-slice, breathhold imaging of the lung with submillisecond echo times. Magn Reson Med 33:678–682PubMedCrossRef

71.

Hatabu H, Gaa J, Tadamura E, et al (1999) MR imaging of pulmonary parenchyma with a half-Fourier single-shot turbo spin-echo (HASTE) sequence. Eur J Radiol 29:152–159CrossRefPubMed

72.

Pengo V, Lensing AWA, Prins MH, et al (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350:2257–2264CrossRefPubMed

73.

Mastora I, Remy-Jardin M, Masson P, et al (2003) Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data. Eur Radiol 13:29–35PubMed

74.

Ley S, Puderbach M, Fink, C et al (2005) Assessment of hemodynamic changes in the systemic and pulmonary arterial circulation in patients with cystic fibrosis using phase-contrast MRI. Eur Radiol 15:1575–1580CrossRefPubMed

75.

Ohno Y, Hatabu H, Higashino T, et al (2004) Dynamic perfusion MRI versus perfusion scintigraphy: prediction of postoperative lung function in patients with lung cancer. AJR Am J Roentgenol 182:73–78PubMed

76.

Moody AR, Liddicoat A, Krarup K (1997) Magnetic resonance pulmonary angiography and direct imaging of embolus for the detection of pulmonary emboli. Invest Radiology 32:431–440CrossRef

77.

Moody AR. Crossley I, Moorby S, Delay G (2003) Magnetic resonance direct thrombus imaging (MR DTI) as a first line investigation for pulmonary embolism—the PDR trial. Proceedings of the 11th annual scientific meeting of the ISMRM, Toronto, Canada

Title: MR imaging of the pulmonary vasculature—an update
Authors: Mark R. Pedersen
Mark T. Fisher
Edwin J. R. van Beek
Publication date: 01-06-2006
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-005-0109-x

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Springer Medicine

MR imaging of the pulmonary vasculature—an update

Abstract

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Abstract

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