DOI: 10.1002/mrm.70546 ISSN: 0740-3194

Correlating Pulmonary Hemodynamics With HP 129 Xe Dissolved‐Phase MRSI Markus Phillip Andersen, Mattias Hedegaard Kristensen, Esben Søvsø Szocska Hansen, Rolf F. Schulte, Mohsen Redda, Uffe Kjærgaard, Michael Vaeggemose, Christoffer Laustsen

ABSTRACT

Purpose

Pulmonary hypertension is related to a 1‐year mortality ranging from < 5% to > 20% in low‐ and high‐risk groups. Right heart catheterization is the diagnostic gold standard, associated with a 1.1% rate of severe adverse events, posing the need for a non‐invasive diagnostic tool. This study aims to delineate the effects of controlled changes on pulmonary hemodynamics by quantifying corresponding changes in hyperpolarized 129 Xe MRSI dissolved‐phase parameters, including RBC oscillations.

Methods

Seven Danish Landrace pigs underwent hyperpolarized 129 Xe dissolved‐phase 3D MRSI with interleaved MRS under baseline conditions and three vasoactive interventions, monitored with invasive catheters or phase‐contrast MRI. Results were evaluated using one‐way ANOVA or mixed‐effects analysis followed by Dunnett's multiple comparisons test.

Results

Hypoxia increased mPAP ( p  = 0.038), reduced RBC:M (−31%, p  = 0.007) and RBC:G (−34%, p  = 0.009), while increasing RBC chemical shift (0.57%, p  = 0.020). Adenosine and dobutamine increased RBC:M (22%, p  = 0.003) and RBC:G (30%, p  = 0.009), while decreasing RBC chemical shift (−0.38%, p  = 0.11). Linear regression revealed an inverse correlation between mPAP and RBC oscillation amplitude ( R 2  = 0.158, p  = 0.04), RBC:M ( R 2  = 0.25, p  = 0.05), and RBC:G ( R 2  = 0.22, p  = 0.01).

Conclusion

This study demonstrates that dissolved‐phase hyperpolarized 129 Xe MRSI parameters are sensitive to hemodynamic changes, exhibiting consistent inverse relationships with invasively measured mPAP. By leveraging concurrent invasive reference measurements, these findings provide physiological validation that dissolved‐phase 129 Xe metrics reflect pulmonary vascular pressure, supporting their further development as a non‐invasive adjunct to right heart catheterization.

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