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Primary Pulmonary Hypertension: 3D Dynamic Perfusion MRI for Quantitative Analysis of Regional Pulmonary Perfusion

¹ Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
² Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215.
³ Department of Medical Engineering, Division of Allied Health Sciences, Osaka University Medical School, Osaka, Japan.

View larger version (121K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —34-year-old healthy female volunteer. PC display of regions of interest. Square = right pulmonary parenchyma, circle = main pulmonary artery trunk, triangle = left pulmonary parenchyma.

View larger version (12K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —34-year-old healthy female volunteer. Graph shows signal intensity-time course curves. Arterial input function was obtained from signal intensity-time course curve of main trunk of pulmonary artery (circles). Squares = right pulmonary parenchyma, triangles = left pulmonary parenchyma, AU = arbitrary units.

View larger version (12K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —34-year-old healthy female volunteer. Graph shows signal intensity-time course curves of right pulmonary parenchyma (squares) and left pulmonary parenchyma (triangles) at lower signal intensity than B. AU = arbitrary units.

View larger version (77K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —33-year-old healthy man. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Pulmonary blood flow (PBF) map shows regional changes in PBF in both lungs. Mean regional PBF in this slice is 128.3 ± 3.3 mL/100 mL/min.

View larger version (75K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —33-year-old healthy man. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Pulmonary blood volume (PBV) map shows regional changes in PBV in both lungs. Mean regional PBV in this slice is 11.7 ± 0.7 mL/100 mL.

View larger version (73K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —33-year-old healthy man. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Mean transit time (MTT) map shows regional changes in MTT in both lungs. Mean regional MTT in this slice is 4.3 ± 0.7 seconds.

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —42-year-old woman with primary pulmonary hypertension. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Pulmonary blood flow (PBF) map clearly shows decreased PBF in both lungs. Mean regional PBF in this slice is 43.9 ± 4.9 mL/100 mL/min.

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —42-year-old woman with primary pulmonary hypertension. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Pulmonary blood volume (PBV) map clearly shows decreased PBV in both lungs. Mean regional PBF in this slice is 5.8 ± 2.5 mL/100 mL.

View larger version (97K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —42-year-old woman with primary pulmonary hypertension. Quantitative pulmonary perfusion parameter maps on one of 10 slices. Mean transit time (MTT) map clearly shows prolonged MTT in both lungs. Mean regional MTT in this slice is 6.9 ± 1.2 seconds.

View larger version (8K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —Graph shows correlation between pulmonary blood flow (PBF) and pulmonary vascular resistance (PVR) in patients with primary pulmonary hypertension. Good negative correlation was observed between PBF and PVR (r = -0.79, r2 = 0.62, p < 0.001).

View larger version (7K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —Graph shows correlation between mean transit time (MTT) and pulmonary vascular resistance (PVR) in patients with primary pulmonary hypertension. Moderate positive correlation was observed between MTT and PVR (r = 0.60, r2 = 0.36, p = 0.022).

View larger version (8K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —Graph shows correlation between pulmonary blood flow (PBF) and mean pulmonary arterial pressure (MPAP) in patients with primary pulmonary hypertension. Moderate negative correlation was observed between PBF and MPAP (r = -0.70, r2 = 0.49, p = 0.005).

View larger version (7K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7 —Graph shows correlation between mean transit time (MTT) and mean pulmonary arterial pressure (MPAP) in patients with primary pulmonary hypertension. Fair positive correlation was observed between MTT and MPAP (r = 0.54, r2 = 0.29, p = 0.048).

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