title: Combined pulmonary fibrosis and emphysema: 3D time-resolved MR angiographic evaluation of pulmonary arterial mean transit time and time to peak enhancement.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Sergiacomi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bolacchi
authors.forename: Marcello
authors.initials: M
authors.lastname: Cadioli
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Angeli
authors.forename: Francesco
authors.initials: F
authors.lastname: Fucci
authors.forename: Sonia
authors.initials: S
authors.lastname: Crusco
authors.forename: Paola
authors.initials: P
authors.lastname: Rogliani
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pezzuto
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Enrica
authors.initials: E
authors.lastname: Mariano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003287:Contrast Media; D004452:Echocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016014:Linear Models; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D011656:Pulmonary Emphysema / Q000150:complications / Q000175:diagnosis*; D011658:Pulmonary Fibrosis / Q000150:complications / Q000175:diagnosis*; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA