MRI model-based non-invasive differential diagnosis in pulmonary hypertension

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Pulmonary Medicine

Background:

• Pulmonary hypertension (PH) is defined by elevated mean pulmonary arterial pressure.
• Current diagnosis of PH necessitates invasive right heart catheterisation (RHC).
• A non-invasive diagnostic approach for PH is highly desirable.

Purpose of the Study:

• To develop and validate a non-invasive diagnostic method for pulmonary hypertension (PH) using only MRI.
• To derive diagnostic parameters from MRI-based measurements of main pulmonary artery (MPA) anatomy and flow.
• To assess the potential of these parameters in differentiating PH severity.

Main Methods:

• Utilized MRI to acquire simultaneous measurements of main pulmonary artery (MPA) anatomy and flow.
• Applied 0D and 1D mathematical models, including a 1D wave equation and an RCR Windkessel model, to interpret MPA flow dynamics.
• Analyzed data from 35 subjects (27 PH patients, 8 healthy volunteers) categorized by disease severity.

Main Results:

• The 1D wave equation model demonstrated an increasing ratio of reflected to incident wave power (Wpb/Wptotal) with PH severity.
• The RCR Windkessel model indicated a rise in distal resistance correlating with increased PH disease status.
• Statistically significant differences in derived parameters were observed across disease severity classifications.

Conclusions:

• The proposed non-invasive MRI-based mathematical models show promise for diagnosing pulmonary hypertension.
• Derived indices correlate with disease severity, suggesting potential for a novel, non-invasive diagnostic test.
• Further development could lead to a safer and more accessible method for PH diagnosis.