Chronic thromboembolic pulmonary hypertension - assessment by magnetic resonance imaging.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease that has been ignored for a long time. However, with the development of improved therapeutic modalities, cardiologists and thoracic surgeons have shown increasing interest in the diagnostic work-up of this entity. The diagnosis and management of chronic thromboembolic pulmonary hypertension require a multidisciplinary approach involving the specialties of pulmonary medicine, cardiology, radiology, anesthesiology and thoracic surgery. With this approach, pulmonary endarterectomy (PEA) can be performed with an acceptable mortality rate. This review article describes the developments in magnetic resonance (MR) imaging techniques for the diagnosis of chronic thromboembolic pulmonary hypertension. Techniques include contrast-enhanced MR angiography (ce-MRA), MR perfusion imaging, phase-contrast imaging of the great vessels, cine imaging of the heart and combined perfusion-ventilation MR imaging with hyperpolarized noble gases. It is anticipated that MR imaging will play a central role in the initial diagnosis and follow-up of patients with CTEPH.
Kreitner
Karl-Friedrich
KF
Department of Diagnostic and Interventional Radiology, Johannes-Gutenberg-University, Langenbeckstrasse 1, D-55131 Mainz, Germany. kreitner@radiologie.klinik.uni-mainz.de
Kunz
R Peter
RP
Ley
Sebastian
S
Oberholzer
Katja
K
Neeb
Daniel
D
Gast
Klaus K
KK
Heussel
Claus-Peter
CP
Eberle
Balthasar
B
Mayer
Eckhard
E
Kauczor
Hans-Ulrich
HU
Düber
Christoph
C
D002908:Chronic Disease; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology