Key result
Automated mPAP estimation from 4D flow MRI diagnoses pulmonary hypertension with ~1.00 AUC.
Why the study?
Elevated mean pulmonary arterial pressure is associated with vortical blood flow along the main pulmonary artery, prompting development of an automated method to detect this vortex from 4D flow MRI and estimate mPAP.
Does automated vortical blood flow-based estimation from 4D flow MRI accurately estimate mean pulmonary arterial pressure compared to visual estimation and right heart catheterization in subjects evaluated for pulmonary hypertension?
Observational (n=32)
Does automated vortical blood flow-based estimation from 4D flow MRI accurately estimate mean pulmonary arterial pressure compared to visual estimation and right heart catheterization in subjects evaluated for pulmonary hypertension?
Effect estimate: AUC 1.00 (95% CI 0.89-1.00)
Automated vortical blood flow-based estimation from 4D flow MRI provides accurate estimation of elevated mean pulmonary arterial pressure, showing excellent agreement with visual analysis and invasive measurements.
PURPOSE: Elevated mean pulmonary arterial pressure (mPAP), or pulmonary hypertension (PH), is associated with vortical blood flow along the main pulmonary artery. We present and validate a method for automated detection and tracking of the PH-related vortex from magnetic resonance 4D flow data that allows estimation of mPAP. METHODS: ) using a previously established model. 4D flow data of 32 subjects (19/13 with/without PH) who underwent right heart catheterization (RHC) for mPAP measurement and diagnosis of PH (mPAP >20 mmHg) were used to compare visual and automated PH-related vortex detection and to validate estimated mPAP against RHC-derived results. RESULTS: values correlated strongly (r = 0.98); they yielded no bias, and the standard deviation of differences between them was small (5.9% of the cardiac interval). mPAP estimates from visual and automated analyses both allowed diagnosis of PH with an area under the curve of 1.00 [0.89,1.00]. For subjects with PH, neither visually nor automatically estimated mPAP differed from mPAP measured by RHC, while the standard deviation between estimated and invasively measured mPAP was lower with visual estimation (3.1 mmHg vs. 5.3 mmHg). CONCLUSION: An automated method for PH-related vortex detection and tracking from magnetic resonance 4D flow data was introduced, which demonstrated very good agreement with visual analysis and accurate estimation of elevated mPAP.
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Kräuter et al. (2022) conducted an observational in Pulmonary hypertension (n=32). Automated vortical blood flow-based estimation of mPAP from 4D flow MRI vs. Visual estimation and right heart catheterization was evaluated on Diagnosis of pulmonary hypertension (AUC 1.00, 95% CI 0.89-1.00). Automated estimation of mean pulmonary arterial pressure from 4D flow MRI allowed diagnosis of pulmonary hypertension with an area under the curve of 1.00 (95% CI 0.89-1.00).
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