Magnetic resonance and nuclear imaging of the right ventricle in pulmonary arterial hypertension

Many clinicians have recognized the unique possibilities of magnetic resonance imaging (MRI) for the study of right ventricular (RV) anatomy. Especially for the assessment of the RV in pulmonary hypertension, MRI has been proven to be of clinical importance. It is, however, less well known that if MRI measures of volume and flow are combined with pressure measurements, accurate description of RV function in relation to its afterload is possible. Furthermore, nuclear imaging techniques offer the opportunity to study the altered RV metabolism and to elucidate the possible contribution of ischaemia to RV failure in pulmonary hypertension. Since RV failure in pulmonary hypertension is the result of the complex interaction between geometry, structure, function, perfusion, and metabolism, MRI and nuclear imaging are promising techniques to study these mechanisms and to evaluate the effects of therapy aimed at improving RV function in pulmonary hypertension.