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Eur Respir J 2005; 25:758-766
Copyright ©ERS Journals Ltd 2005

Noninvasive assessment and monitoring of the pulmonary circulation

A. Vonk-Noordegraaf1, S. A. van Wolferen1, J. T. Marcus2, A. Boonstra1, P. E. Postmus1, J. W. L. Peeters3 and A. J. Peacock4

1 Dept of Pulmonology, 2 Dept of Physics and Medical Technology, and 3 Dept of Radiology, VU University Medical Center, Amsterdam, The Netherlands. 4 Scottish Pulmonary Vascular Unit, Western Infirmary, Glasgow, UK

CORRESPONDENCE: A. Vonk-Noordegraaf, Dept of Pulmonology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Fax: 31 20444328. E-mail: a.vonk@Vumc.nl

Keywords: Acetylene diffusion, computed tomography, electrical impedance tomography, magnetic resonance imaging, perfusion, pulmonary hypertension

Received: October 25, 2004
Accepted December 28, 2004

ABSTRACT

In pulmonary vascular disease, changes in the pulmonary vascular bed will lead to altered pulmonary haemodynamics. This review describes the application of several physiological principles to measure these changes noninvasively by means of novel techniques.

Flow characteristics of blood through the pulmonary vascular bed alter in pulmonary vascular disease. Recent developments in magnetic resonance imaging and computed tomography make it possible to visualise and quantify these abnormal flow patterns. Information regarding pulmonary perfusion can also be obtained by measuring the electrical impedance changes in the lung by electrical impedance tomography. A more indirect approach to measure the pulmonary blood flow is the measurement of the absorption of acetylene, a perfusion limited gas. Information on the pulmonary vascular bed can also be obtained by the measurement of exhaled products of the pulmonary vascular endothelium, such as nitric oxide.

Although all the techniques described offer new ways to diagnose or monitor pulmonary vascular disease, clinical data on these techniques are limited. Further improvement and evaluation of the clinical value of these techniques are therefore obligatory before they can be used in clinical practice.






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Copyright © 2005 by the European Respiratory Society.