European researchers have confirmed that MRI isn’t precise enough at assessing pulmonary hypertension to outright preclude right-heart catheterization. However, they’ve also shown that the advanced imaging pathway can appropriately supplement echocardiography to avoid such catheterization for patients who may not need the intervention.
The researchers, from the University of Lorraine in France, used both right-heart cath and cardiac MRI to assess 56 consecutive patients who’d already undergone echocardiography.
After reviewing all the relevant literature to set MRI parameters for pulmonary hypertension, Clément Venner and colleagues looked for multivariate linear relations between those parameters and the mean pulmonary arterial pressure (mPAP). They then used logistic regression to calculate the ability of those parameters to diagnose the condition.
Specificity was not stellar (click here for summary results), but “the prediction of pulmonary hypertension within the population was feasible and the method yielded a specificity of 80 percent for a sensitivity of 100 percent,” they report in their study, which was published online June 8 in Acta Radiologica.
“The performance of MRI to assess mPAP is too low to be used as a replacement for right heart catheterization,” they conclude, “but MRI could be used as second line examination after echocardiography to avoid right heart catheterization for normal patients.”