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Magnetic resonance imaging in pediatric pulmonary hypertension
Insights
Cardiovascular magnetic resonance imaging effectively diagnoses pediatric pulmonary hypertension. A main pulmonary artery diameter of ≥25 mm indicates high sensitivity and specificity for diagnosing this condition in children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Diagnostic Accuracy
Background:
- Pulmonary hypertension (PH) in children poses diagnostic and prognostic challenges.
- Accurate assessment of PH is crucial for timely intervention and improved outcomes.
- Cardiovascular magnetic resonance imaging (CMR) offers a non-invasive imaging modality.
Purpose of the Study:
- To evaluate the efficacy and reliability of CMR for diagnosing and predicting prognosis in pediatric pulmonary hypertension (PPH).
- To compare CMR findings in children with PPH against a healthy control group.
- To determine specific CMR metrics associated with PPH diagnosis and severity.
Main Methods:
- Retrospective study comparing 25 children with PPH (mean pulmonary artery pressure ≥25 mmHg by catheter angiography) and 19 healthy controls.
- Analysis of cardiovascular magnetic resonance imaging data, including main pulmonary artery diameter, ascending aorta diameter, and their ratio.
- Correlation of CMR findings with New York Heart Association (NYHA) functional class.
Main Results:
- Children with PPH exhibited significantly lower body mass indices and larger main pulmonary artery and ascending aorta diameters compared to controls.
- A main pulmonary artery diameter ≥25 mm demonstrated 72% sensitivity and 84% specificity for diagnosing PPH.
- Children with NYHA functional class III PPH had significantly larger main, right, and left pulmonary arteries than those with functional class II.
Conclusions:
- Cardiovascular magnetic resonance imaging is a valuable tool for diagnosing pulmonary hypertension in children.
- A main pulmonary artery diameter ≥25 mm is a reliable indicator for diagnosing pediatric pulmonary hypertension with high sensitivity and specificity.
- CMR can aid in assessing the severity and prognosis of pediatric pulmonary hypertension.
Abstract:
The present study aims to determine the efficacy and reliability of cardiovascular magnetic resonance imaging in establishing the diagnosis and prognosis of pulmonary hypertension in children. This is a retrospective comparison of 25 children with pulmonary hypertension and a control group comprising 19 healthy children. The diagnosis of pulmonary hypertension was made when the mean pulmonary artery pressure was ≥25 mmHg by catheter angiography. The children with pulmonary hypertension had significantly lower body mass indices than did the healthy children (P=0.048). In addition, the children with pulmonary hypertension had significantly larger main pulmonary artery diameters and ascending aortic diameters (both P=0.001) but statistically similar ratios of main pulmonary artery diameter-to-ascending aortic diameter. If the main pulmonary artery diameter was ≥25 mm, pediatric pulmonary hypertension was diagnosed with 72% sensitivity and 84% specificity. In the event that the ratio of main pulmonary artery diameter-to-ascending aorta diameter was ≥1, pediatric pulmonary hypertension was diagnosed with 60% sensitivity and 53% specificity. When compared with children who had New York Heart Association functional class II pulmonary hypertension, the children with functional class III pulmonary hypertension had significantly larger main (P=0.046), right (P=0.036), and left (P=0.003) pulmonary arteries. Cardiovascular magnetic resonance imaging is useful in the diagnosis of children with pulmonary hypertension. Pediatric pulmonary hypertension can be diagnosed with high sensitivity and specificity when the main pulmonary artery diameter measures ≥25 mm.
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