Complete assessment of the pulmonary circulation should include not only the anatomy of the pulmonary arteries and veins but also the functional and hemodynamic consequences of the pathology. The available tools for the pulmonary vascular assessment include: catheterization with x-ray angiography, echocardiography, magnetic resonance (MR), computed tomography (CT), and radioisotope scintigraphy. As each has its own advantages and disadvantages, proper selection of a diagnostic tool or tools should be tailored to the specific purpose of the study in a given patient. Utilization of the imaging resources for anatomical depiction of the pulmonary arteries and veins has well been described in the literature. This chapter discusses the functional and hemodynamic assessment of the pulmonary circulation with particular emphasis on utilization of MR and how we perform functional and hemodynamic evaluation of the pulmonary circulation in a few selected clinical situations.
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