The value of hepatic diffusion-weighted MR imaging in demonstrating hepatic congestion secondary to pulmonary hypertension

Cardiovascular Ultrasound

Research

Yuksel Dogan¹  Kenan Sonmez²  Kadriye Orta Kilickesmez³  Aliye Soylu⁴  Sule Poturoglu⁵  Isa Sevindir⁶  Nurgul Yasar⁶  Tuna Demirtas⁷  Sebahat Nacar Dogan⁸  Ozgur Kilickesmez⁹  Gulay Eren^1,10 

[1] Department of Cardiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey;Department of Cardiology, Cardiology Clinic, Kosuyolu Heart and Research Hospital, Istanbul, Turkey;Department of Cardiology, Institute of Cardiology, Istanbul University, Istanbul, Turkey;Department of Gastroenterology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey;Department of Gastroenterology, Haseki Education and Research Hospital, Istanbul, Turkey;Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey;Department of Radiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey;Department of Radiology, Taksim Education and Research Hospital, Istanbul, Turkey;Department of Radiology, Yeditepe University, Istanbul, Turkey;Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey;

关键词: Apparent Diffusion Coefficient;    Inferior Vena Cava;    Hepatic Vein;    Right Ventricle;    Right Atrium;   

DOI  :  10.1186/1476-7120-8-28

 received in 2010-04-27, accepted in 2010-07-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundCongestive hepatomegaly might be the first sign for pulmonary hypertension. Apparent diffusion coefficient (ADC) value obtained with quantitative diffusion-weighted magnetic resonance imaging (DW-MRI) is affected by liver fibrosis and perfusion. We aimed to evaluate the diagnostic value of DW-MRI in cooperation with biochemical markers, ultrasonography (US) and echocardiography (TTE) in determining the degree of hepatic congestion secondary to pulmonary hypertension (PHT).Methods35 patients with PHT and 26 control subjects were included in the study. PHT was diagnosed if pulmonary artery systolic pressure (PASP) was measured above 35 mmHg with TTE. Study group was classified into mild and moderate PHT. DW-MRI was performed with b-factors of 0, 500 and 1000 sec/mm². Mean ADC, ADC-II (Average of the ADC values of right lobe anterior and posterior segments), US, TTE and blood biochemical parameters of both groups were compared.ResultsThere exists a positive correlation between liver size and the diameters of vena cava inferior, right atrium, right hepatic vein(RHV), mid-hepatic vein(MHV), left hepatic vein(LHV) (p < 0.01). There was a positive correlation between PASP and RHV, MHV, LHV. The patients had lower ejection fractions (p < 0.01) and higher LDH (p < 0.01) and ALP (p < 0.05) levels than the control group. The ADC values of the patients with moderate PASP were higher than those with a mild PASP (p < 0.05). Mean ADC was higher in patients with moderate PHT compared to control group (p = 0.009). There was a positive correlation between PASP and ADC values of right lobe posterior segment of the liver (p < 0.05). The ADC-II and mean ADC values of the patients with moderate PASP were higher than those of the control group (p < 0.01).ConclusionsCongestion due to moderate PHT might be diagnosed with DW-MRI. As PASP increase; mean ADC and ADC-II values increase.

【 授权许可】

CC BY   
© Dogan et al; licensee BioMed Central Ltd. 2010