Magnetic Resonance Imaging in Pediatric Pulmonary Hypertension

Abstract

The present study aims to determine the efficacy and reliability of cardiovascular magnetic resonance imaging in establishing the diagnosis and prognosis of pulmonary hypertension in children. This is a retrospective comparison of 25 children with pulmonary hypertension and a control group comprising 19 healthy children. The diagnosis of pulmonary hypertension was made when the mean pulmonary artery pressure was ≥25 mmHg by catheter angiography. The children with pulmonary hypertension had significantly lower body mass indices than did the healthy children (P=0.048). In addition, the children with pulmonary hypertension had significantly larger main pulmonary artery diameters and ascending aortic diameters (both P=0.001) but statistically similar ratios of main pulmonary artery diameter-to-ascending aortic diameter. If the main pulmonary artery diameter was ≥25 mm, pediatric pulmonary hypertension was diagnosed with 72% sensitivity and 84% specificity. In the event that the ratio of main pulmonary artery diameter-to-ascending aorta diameter was ≥1, pediatric pulmonary hypertension was diagnosed with 60% sensitivity and 53% specificity. When compared with children who had New York Heart Association functional class II pulmonary hypertension, the children with functional class III pulmonary hypertension had significantly larger main (P=0.046), right (P=0.036), and left (P=0.003) pulmonary arteries. Cardiovascular magnetic resonance imaging is useful in the diagnosis of children with pulmonary hypertension. Pediatric pulmonary hypertension can be diagnosed with high sensitivity and specificity when the main pulmonary artery diameter measures ≥25 mm.

El aumento asimétrico del diámetro de la arteria pulmonar no siempre es secundario a hipertensión arterial pulmonar

“…Además, permite visualizar los defectos cardíacos, el parénquima pulmonar y la vasculatura. También se realizan cálculos de volúmenes, como fracción de eyección, y volúmenes de fin de sístole y diástole (18). Adicionalmente, se ha descrito que al conjugar medidas computacionales con los hallazgos en resonancia magnética se pueden reflejar cambios hemodinámicos en la vasculatura pulmonar, proporcionando un método no invasivo que aporta más datos y diagnósticos diferenciales para la evaluación de la hipertensión pulmonar (17).…”