Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Radiology. 2010 Feb;254(2):601-8. doi: 10.1148/radiol.09081546.
To correlate conventional invasive pressure indexes of pulmonary circulation with pulmonary first-order arterial mean transit time (MTT) and time to peak enhancement (TTP) measured by means of three-dimensional time-resolved magnetic resonance (MR) angiography in patients with combined pulmonary fibrosis and emphysema (CPFE).
The study was institutional review board approved. All subjects involved in the study provided written informed consent. Eighteen patients with CPFE were enrolled in this study. Thirteen healthy individuals matched for age and sex served as control subjects. Three-dimensional time-resolved MR angiography was performed by using a 3.0-T MR imager. Regions of interest (ROIs) were drawn manually on first-order pulmonary arteries. Within the ROIs, signal intensity-versus-time curves reflecting the first pass of the contrast agent bolus in the pulmonary vessels were obtained. MTT and TTP were calculated. Pulmonary arterial pressure and pulmonary capillary wedge pressure were measured with a double-lumen, balloon-tipped catheter that was positioned in the pulmonary artery. The mean pulmonary arterial pressure (mPAP) and the pulmonary vascular resistance (PVR) were determined.
MTT and TTP values were prolonged significantly in patients with CPFE compared with those in the control subjects (P < .001). Mean TTP and mean MTT correlated directly with mPAP and PVR index (P < .005). At multiple linear regression analysis, MTT was the only factor independently associated with PVR index and mPAP.
Three-dimensional time-resolved MR angiography enables determination of pulmonary hemodynamic parameters that correlate significantly with the pulmonary hemodynamic parameters obtained with invasive methods and may represent a complementary tool for evaluating pulmonary hypertension in patients with CPFE.
在患有肺纤维化合并肺气肿（CPFE）的患者中，通过三维时间分辨磁共振（MR）血管造影术测量肺循环的常规侵入性压力指数与肺一级动脉平均通过时间（MTT）和峰值增强时间（TTP），并将两者进行相关性分析。
本研究获得机构审查委员会批准，所有参与研究的患者均提供书面知情同意书。本研究纳入 18 例 CPFE 患者，另外选取 13 例年龄和性别相匹配的健康个体作为对照组。使用 3.0T MR 成像仪进行三维时间分辨 MR 血管造影。手动在一级肺动脉上绘制感兴趣区（ROI）。在 ROI 内，获得反映肺动脉内对比剂团首过的信号强度-时间曲线。计算 MTT 和 TTP。通过置于肺动脉内的双腔球囊尖端导管测量肺动脉平均压（mPAP）和肺血管阻力（PVR）。
CPFE 患者的 MTT 和 TTP 值明显长于对照组（P<0.001）。平均 TTP 和平均 MTT 与 mPAP 和 PVR 指数呈正相关（P<0.005）。多元线性回归分析显示，MTT 是与 PVR 指数和 mPAP 独立相关的唯一因素。
三维时间分辨 MR 血管造影术可确定与侵入性方法获得的肺血流动力学参数显著相关的肺血流动力学参数，可能是评估 CPFE 患者肺动脉高压的一种补充工具。
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