OC 42.2 - Phase-Resolved Functional Lung (PREFUL)-MRI-derived Functional Parameters in Evaluation of Chronic Thromboembolic Pulmonary Hypertension: a prospective study

Monday, June 24, 2024

15:00 – 15:15 ICT

Room: Ballroom B2

Presenting Author(s)

Linfeng Xi, MD

resident physician
China-Japan Friendship Hospital
Beijing, Beijing, China (People's Republic)

Co-Author(s)

YN

Yifei Ni

resident physician
Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China. Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Beijing, Beijing, China (People's Republic)
JW

Jianping Wang

resident physician
Capital Medical University, Beijing 100069, China. Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)
HY

Haoyu Yang

resident physician
Department of Radiology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100191, China.
Beijing, Beijing, China (People's Republic)
SZ

Shuai Zhang

attending physician
National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)
ZZ

Zhu Zhang

attending physician
China-Japan Friendship Hospital
Beijin, Beijing, China (People's Republic)
AL

Anqi Liu

resident physician
Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China. Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Beijing, Beijing, China (People's Republic)
QH

Qiang Huang

Professor
China-Japan Friendship hospital
Beijing, Beijing, China (People's Republic)
WX

Wanmu Xie

Professor
China-Japan Friendship hospital
Beijing, Beijing, China (People's Republic)
SW

Shiyao Wang

attending physician
National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)
QG

Qian Gao

attending physician
National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)
AV

Andreas Voskrebenzev

Ph.D.
Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Hannover, Niedersachsen, Germany
JC

Jens Vogel Claussen

M.D.
Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Hannover, Niedersachsen, Germany
ML

Min Liu

attending physician
Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)
Zhenguo Zhai, MD,PhD

professor
China-Japan Friendship Hospital, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China
Beijing, Beijing, China (People's Republic)
CW

Chen Wang

attending physician
National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Beijing, Beijing, China (People's Republic)

Background: Medical imaging plays a crucial role in evaluation of chronic pulmonary embolism (CPE). Phase-resolved functional lung magnetic resonance imaging (PREFUL-MRI) is a radiation-free, contrast agent-free and free-breath pulmonary functional imaging technique, which can supply information of pulmonary perfusion and ventilation.

Aims: To compare lung perfusion and ventilation metrics derived from PREFUL-MRI between chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) and study the correlation between functional metrics and clinical severity.

Methods: Patients with CPE were prospectively enrolled. All patients underwent PREFUL-MRI and right heart catheterization. PREFUL-derived functional metrics including perfusion and ventilation defect percentages between CTEPH and CTEPD were compared and its correlation with hemodynamics and clinical data were analyzed.

Results: 118 CTE patients including 86 patients with CTEPH [62(42-67) years; 48 males] and 32 patients with CTEPD [46(33-67) years; 14 males] were enrolled. CTEPH group had a much higher perfusion defects percentages compared with CTEPD group [36.4% (21.7-57.0) vs 7.6% (5.1-16.3), P< 0.001]. Among perfusion metrics，QDPtotal, percentage of perfusion defects in total, strongest correlated with hemodynamics data (ρ=0.63, P< 0.001). Moreover, QDPtotal modestly correlated with six‐minute walk distance (ρ=0.55, P< 0.001), N-terminal pro-brain natriuretic peptide (ρ=0.58, P< 0.001) and World Health Organization functional class (ρ=0.55, P< 0.001). ROC showed the areas under the curve of QDPtotal in CTEPH diagnosis and risk stratification were 0.860 and 0.804, respectively. And the cutoff value of QDPtotal in 19.3% indicated pulmonary hypertension.

Conclusion(s): PREFUL-MRI quantified the regional perfusion metrics exhibit the potential value in evaluating severity of CPE.