Daniel Maxien MD, Presenter: Nothing to Disclose

Olaf Dietrich, Abstract Co-Author: Nothing to Disclose

Sven Florian Thieme MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Nothing to Disclose

CTEPH is one of the most common causes of pulmonary hypertension (PH). A suitable diagnostic modality providing morphologic and functional information is desirable, because the therapy of CTEPH differs considerably from therapies in other causes of PH. Dynamic oeMRI, displaying ventilation, perfusion and diffusion of the lungs, may be a helpful tool, but the qualitative analysis of oeMR images is sometimes difficult. A quantitative parameter, which correlates with the severity of CTEPH, may be helpful in these cases.

10 patients with CTEPH underwent ventilation/perfusion scintigraphy (V/Q scintigraphy), computed tomography (CT) and dynamic oeMRI on a 1.5 T MR scanner. The oeMRI data was assessed by performing a cross-correlation coefficient analysis (CCC). This analysis offers the possibility to calculate the fraction of oxygen-activated pixels (fOAP) and the mean cross-correlation coefficient (mCCC) as quantitative parameters. In addition, the scintigraphy data and the oeMRI data were qualitatively evaluated by blinded reviewers. For this purpose, each lung was segmented, and six areas per patient were evaluated, regarding the existence of defects. The correlations were calculated with the Kendall tau rank correlation coefficient (one-sided).

A significant correlation was observed between the visual assessed number of diseased lung areas in the perfusion scintigraphy data and in the oeMRI data. (p < 0.05). In addition to this qualitative evaluation, the quantitative parameters fOAP and mCCC showed a significant correlation with the qualitatively evaluated number of diseased lung areas in perfusion scintigrapy and in CCC images (p < 0.05).

oeMRI is a feasible technique in patients suffering from CTEPH, yielding a high agreement comparing CCC images with perfusion scintigraphy. In addition, our study indicates that the fOAP and the mCCC may be helpful quantitative tools to assess the severity of CTEPH.

Dynamic oeMRI is a suitable method for diagnosis in CTEPH, providing morphological and functional information. Moreover, its quantitative parameters may be helpful tools to assess severity of CTEPH.

Maxien, D, Dietrich, O, Thieme, S, Reiser, M, Nikolaou, K, Dynamic Oxygen-enhanced Magnetic Resonance Imaging (oeMRI) in Patients Suffering from Chronic Thromboembolic Pulmonary Hypertension (CTEPH): A Quantitative Approach.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009115.html