Value of oxygen-enhanced MRI of the lungs in patients with pulmonary hypertension: a qualitative and quantitative approach.

Purpose: 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.

Materials And 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).

Conclusion: 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.