title: Value of oxygen-enhanced MRI of the lungs in patients with pulmonary hypertension: a qualitative and quantitative approach.
abstract: OBJECTIVE
  To assess the clinical value of oxygen-enhanced magnetic resonance imaging (oeMRI) in patients with pulmonary hypertension (PH) by correlation with ventilation/perfusion (V/Q) scintigraphy.
  
  
  METHODS
  In all, 33 patients with known PH underwent V/Q scintigraphy and oeMRI. oeMRI was used to assess the regional pulmonary function based on relative-signal-enhancement (RSE) and cross-correlation-coefficient (CCC) maps, evaluating mean RSE (mRSE), fraction of oxygen-activated pixels (fOAP), and mean CCC (mCCC). Two reviewers, blinded to the results of scintigraphy, performed visual detection of diseased lung areas.
  
  
  RESULTS
  In 26 of the 33 patients (79%) the image quality of oeMRI reached a diagnostic level. In total, 150 lung areas were analyzed and compared. Sensitivities/specificities of oeMRI for detecting these defects were: RSE vs. ventilation scintigraphy 92%/73%; RSE vs. perfusion scintigraphy 60%/87%; CCC vs. ventilation scintigraphy 89%/81%; CCC vs. perfusion scintigraphy 50%/87%. The number of diseased lung areas in oeMRI correlated significantly with the number in V/Q scintigraphy (P < 0.01). mRSE showed a significant correlation with the number of diseased lung areas in ventilation scintigraphy (P < 0.05).
  
  
  CONCLUSIONS
  oeMRI is feasible in PH patients, yielding an overall moderate agreement between oeMRI and V/Q scans, with a good sensitivity of oeMRI for the detection of ventilation defects as compared with ventilation scintigraphy.
authors.affiliation: Department of Clinical Radiology, University Hospitals Munich, Grosshadern Campus, Munich, Germany. daniel.maxien@med.uni-muenchen.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Maxien
authors.forename: Olaf
authors.initials: O
authors.lastname: Dietrich
authors.forename: Sven F
authors.initials: SF
authors.lastname: Thieme
authors.forename: Stefan
authors.initials: S
authors.lastname: Förster
authors.forename: Jürgen
authors.initials: J
authors.lastname: Behr
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000473:pathology* / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry*; D011877:Radionuclide Imaging / Q000379:methods; D012680:Sensitivity and Specificity; D014692:Ventilation-Perfusion Ratio
chemical_list: D010100:Oxygen