Guo Xiaojuan, Liu Min, Ma Zhanhong, Wang Shuangkun, Yang Yuanhua, Zhai Zhenguo, Wang Chen, Zhai Renyou
Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Diagn Interv Radiol. 2014 Sep-Oct;20(5):414-20. doi: 10.5152/dir.2014.13501.
We aimed to determine the correlation between flow characteristics of the proximal pulmonary arteries and vena cava obtained by 3.0 T phase-contrast magnetic resonance imaging (MRI) and hemodynamic characteristics by right heart catheterization in patients with chronic thromboembolic pulmonary hypertension.
Twenty consecutive patients with chronic thromboembolic pulmonary hypertension and 20 sex- and age-matched healthy volunteers were included prospectively. All patients and controls underwent phase-contrast MRI to determine the flow characteristics including peak velocity, mean velocity, and mean blood flow of the proximal pulmonary artery and vena cava. All patients underwent right heart catheterization to determine the hemodynamics.
Peak velocity and mean velocity of the proximal pulmonary artery were significantly lower in the patient group. In patients, both peak velocity and mean blood flow were sequentially decreased in the main pulmonary artery, left and right pulmonary arteries, and left and right interlobar pulmonary arteries. Inferior vena cava had higher peak velocity, mean velocity, and mean blood flow than superior vena cava. Peak velocity of the main pulmonary artery correlated with mean and diastolic pulmonary artery pressure. Peak velocity of both inferior and superior vena cava strongly correlated with the pulmonary vascular resistance index (PVRI) (r=-0.68, P < 0.001 and r=-0.74, P < 0.001, respectively). Mean velocity of the main pulmonary artery and right pulmonary artery strongly correlated with PVRI and mean pulmonary artery pressure. Mean velocity of the superior vena cava and mean blood flow of the main pulmonary artery strongly correlated with PVRI and right cardiac work index.
Blood flow in the proximal pulmonary artery and vena cava evaluated by phase-contrast MRI correlate with hemodynamic parameters of right heart catheterization and can be used to noninvasively evaluate the severity of chronic thromboembolic pulmonary hypertension and, potentially, to follow up the treatment response.
我们旨在确定慢性血栓栓塞性肺动脉高压患者中，通过3.0 T相位对比磁共振成像（MRI）获得的近端肺动脉和腔静脉的血流特征与右心导管检查的血流动力学特征之间的相关性。
前瞻性纳入20例连续的慢性血栓栓塞性肺动脉高压患者以及20名年龄和性别匹配的健康志愿者。所有患者和对照均接受相位对比MRI检查，以确定近端肺动脉和腔静脉的血流特征，包括峰值速度、平均速度和平均血流量。所有患者均接受右心导管检查以确定血流动力学。
患者组近端肺动脉的峰值速度和平均速度显著降低。在患者中，主肺动脉、左右肺动脉以及左右叶间肺动脉的峰值速度和平均血流量均依次降低。下腔静脉的峰值速度、平均速度和平均血流量均高于上腔静脉。主肺动脉的峰值速度与平均肺动脉压和舒张期肺动脉压相关。下腔静脉和上腔静脉的峰值速度均与肺血管阻力指数（PVRI）密切相关（分别为r = -0.68，P < 0.001和r = -0.74，P < 0.001）。主肺动脉和右肺动脉的平均速度与PVRI和平均肺动脉压密切相关。上腔静脉的平均速度和主肺动脉的平均血流量与PVRI和右心做功指数密切相关。
通过相位对比MRI评估的近端肺动脉和腔静脉血流与右心导管检查的血流动力学参数相关，可用于无创评估慢性血栓栓塞性肺动脉高压的严重程度，并可能用于随访治疗反应。
