The gold standard for imaging pulmonary congestion is chest radiography however this test provides largely qualitative information. BNP, a plasma biomarker of raised intra-cardiac pressure, is also used to evaluate patients with heart failure however pulmonary congestion is also influenced by other components of Starling's equation as well as lymphatic drainage. Therefore, there are few methods that directly measure pulmonary congestion, one of the cardinal features of heart failure. MRI is well suited to image pulmonary edema given that signal intensity is directional proportional to water content and cardiac MRI is increasingly used to evaluate patients with heart failure. Following this activity, learns will understand that MRI signal intensity in the lung can be used as a surrogate for pulmonary congestion, MRI derived lung water has moderate correlation with measures of intra-cardiac pressures (BNP and catheter derived) and are associated with outcome in patients with heart failure, and lung water imaging could be easily added to existing cardiac MRI protocols.
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