Abstract
Imaging plays a central role in the diagnosis and management of all forms of pulmonary hypertension (PH). Although Doppler echocardiography is essential for the evaluation of PH, its ability to optimally evaluate the right ventricle and pulmonary vasculature is limited by its 2-dimensional planar capabilities. Magnetic resonance and computed tomography are capable of determining the etiology and pathophysiology of PH, and can be very useful in the management of these patients. Exciting new techniques such as right ventricle tissue characterization with T1 mapping, 4-dimensional flow of the right ventricle and pulmonary arteries, and computed tomography lung perfusion imaging are paving the way for a new era of imaging in PH. These imaging modalities complement echocardiography and invasive hemodynamic testing and may be useful as surrogate endpoints for early phase PH clinical trials. Here we discuss the role of magnetic resonance imaging and computed tomography in the diagnosis and management of PH, including current uses and novel research applications, and we discuss the role of value-based imaging in PH.
Original language | English (US) |
---|---|
Pages (from-to) | 715-732 |
Number of pages | 18 |
Journal | JACC: Cardiovascular Imaging |
Volume | 9 |
Issue number | 6 |
DOIs | |
State | Published - 2016 |
Funding
Dr. Freed is funded by research grants from the International Society of Heart and Lung Transplantation and Northwestern Memorial Foundation. Dr. Collins is funded by research grants from the Radiological Society of North America Research and Education Foundation, the Society of Interventional Radiology Foundation, and Bard Access Systems. Dr. Barker is funded by a research grant from the National Institutes of Health (K25HL119608). Dr. Cuttica receives research grants from United Therapeutics and Actelion; serves on the advisory boards of United Therapeutics, Gilead, Actelion and Bayer; and is a member of the Speakers Bureaus of United Therapeutics, Gilead, and Actelion. Dr. Chesler is funded by research grants from the National Institutes of Health (R01 HL086939 and R01 HL105598). Dr. Markl is funded by research grants from the National Institutes of Health (R01 HL115828 and R01 HL117888). Dr. Shah is funded by research grants from the National Institutes of Health (R01 HL107557 and R01 HL127028), Actelion, and Novartis.
Keywords
- anatomy
- computed tomography
- magnetic resonance imaging
- physiology
- pulmonary hypertension
- pulmonary vasculature
- right ventricle
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine