Evaluation of a resistance-based model for the quantification of pulmonary arterial hypertension using MR flow measurements

Purpose: To establish an estimate for the mean pulmonary arterial pressure (mPAP) derived from noninvasive data acquired with magnetic resonance (MR) velocity-encoded sequences. Materials and Methods: In seven sedated pigs synchronous catheter-based invasive pressure measurements (IPM) and noninvasive MR were acquired in the main pulmonary artery (MPA) at different severities of pulmonary arterial hypertension (PAH) that were caused by infusion of thromboxane A2 (TxA2). The invasively measured mPAP was correlated with the noninvasive MR velocity data and linear combination equations (LCE) were computed. Results: Intravenously applied TYA2 induced a dose dependent level of severity of PAH with an mPAP of up to 54 mmHg without systemic effects. The acceleration time (AT) measured with MR demonstrated the best correlation with the mPAP (r(2) = 0.75). The LCE with the highest correlation (R = 0.945, alpha < 0.01) between IPM and MRrevealed a mean difference of 0, a SD of s = 4.66 and a maximal difference of 12.2 mmHg using the Bland-Altman analysis. Conclusion: Applying the identified LCE allowed the estimation of the mPAp in an acute and resistance-based model of PAH with high accuracy using noninvasive MR velocity- encoded sequences.