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European Radiology
Published in: European Radiology 11/2005

01-11-2005 | Chest

Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results

Authors: Sebastian Ley, Christian Fink, Julia Zaporozhan, Mathias M. Borst, F. Joachim Meyer, Michael Puderbach, Monika Eichinger, Christian Plathow, Ekkehard Grünig, Karl-Friedrich Kreitner, Hans-Ulrich Kauczor

Published in: European Radiology | Issue 11/2005

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Abstract

Differentiation between different forms of pulmonary hypertension (PH) is essential for correct disease management. The goal of this study was to elucidate the clinical impact of high spatial resolution MR angiography (SR-MRA) and time-resolved MRA (TR-MRA) to differentiate between patients with chronic thromboembolic PH (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). Ten PH patients and five volunteers were examined. Twenty TR-MRA data sets (TA 1.5 s) and SR-MRA (TA 23 s) were acquired. TR-MRA data sets were subtracted as angiography and perfusion images. Evaluation comprised analysis of vascular pathologies on a segmental basis, detection of perfusion defects, and bronchial arteries by two readers in consensus. Technical evaluation comprised evaluation of image quality, signal-to-noise ratio (SNR) measurements, and contrast-media passage time. Visualization of the pulmonary arteries was possible down to a subsegmental (SR-MRA) and to a segmental (TR-MRA) level. SR-MRA outperformed TR-MRA in direct visualization of intravascular changes. Patients with IPAH predominantly showed tortuous pulmonary arteries while in CTEPH wall irregularities and abnormal proximal-to-distal tapering was found. Perfusion images showed a diffuse pattern in IPAH and focal defects in CTEPH. TR-MRA and SR-MRA resulted in the same final diagnosis. Both MRA techniques allowed for differentiation between IPAH and CTEPH. Therefore, TR-MRA can be used in the clinical setting, especially in dyspneic patients.
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Metadata
Title
Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results
Authors
Sebastian Ley
Christian Fink
Julia Zaporozhan
Mathias M. Borst
F. Joachim Meyer
Michael Puderbach
Monika Eichinger
Christian Plathow
Ekkehard Grünig
Karl-Friedrich Kreitner
Hans-Ulrich Kauczor
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
European Radiology / Issue 11/2005
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-005-2792-z

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