Mri of the Chest in Assessing the Severity of Pulmonary Arterial Hypertension in Patients Underwent Covid-19

Abstract

Background. Chest MRI allows diagnosing in the acute period of covid-associated pneumonia (CAP) and assessing the dynamics of treatment. The potential of MRI in postcovid pulmonary arterial hypertension (PAH) study remains unclear. Objective. To examine the chest MRI picture in CAP patients and to quantify the signs of post-COVID PAH. Design and methods. The study included 34 patients who underwent COVID-19 within 3.5–7 months with involvement of the parenchyma of mild severity upon admission of CT1–CT3 according to spiral X-ray CT. All patients underwent chest MRI in ECG- and respiratory-synchronized T1- (T1-WI), T2 (T2-WI) and diffusion-weighted MRI protocols and ultrasound of the heart and large vessels of the chest cavity, with the calculation of systolic pressure in the right ventricle (SPRV). Results. Three groups were distinguished: CT1 (group 1), CT2 (group 2) and CT3 (group 3). The frequency of subsegmental/segmental signs of LA branches thromboembolism was significantly higher in groups CT2 and CT3. LA diameter, SPRV and T1-WI intensity ratio index {Lung/LA} progressively increased from group 1 to group 3. The dependence of SPRV on the {Lung/LA} was fitted using Boltzmann curve (r = 0.92, p < 0.01). Conclusion. Chest MRI in T1- WI allows assessing the degree of post-covid changes in the lung parenchyma thickness and predicting early forms of increased pulmonary arterial pressure and the formation of PAH.