| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee
2 From the Department of Radiology, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee
3 From the Division of Cardiovascular Medicine, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee
4 From the Department of Cardiothoracic Surgery, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee
Objective: To determine the utility of CT-determined main pulmonary artery diameter (MPAD) for predicting pulmonary hypertension (PH) in patients with parenchymal lung disease.
Design: Retrospective review of right-heart hemodynamic data and chest CT scans in 45 patients.
Setting: Tertiary-referral teaching hospital and VA hospital.
Patients: Between October 1990 and December 1995, 36 patients referred for evaluation of parenchymal lung disease or possible pulmonary vascular disease were found to have PH, as defined by mean pulmonary artery pressure (mPAP) 
20 mm Hg. Nine control patients (mPAP <20 mm Hg) were also identified (4 from hospital records search, 5 after evaluation for possible PH).
Results: CT-determined MPAD was 35±6 mm in patients with PH and 27±2 mm in control subjects. In our group of patients, MPAD 29 mm had a sensitivity of 87%, specificity of 89%, positive predictive value (PPV) of 0.97, and positive likelihood ratio (LR) of 7.91 for predicting PH; in the subgroup of patients with parenchymal lung disease (n=28, PH and control subjects), MPAD 29 mm had a sensitivity of 84%, specificity of 75%, PPV of 0.95, and positive LR of 3.36 for predicting PH. The most specific findings for the presence of PH were both MPAD 29 mm and segmental artery-to-bronchus ratio >1:1 in three or four lobes (specificity, 100%). There was no linear correlation between the degree of PH and MPAD (r=0.124).
Conclusions: CT-determined MPAD has excellent diagnostic value for detection of PH in patients with advanced lung disease. Therefore, standard chest CT scans can be used to screen for PH as a cause of exertional limitation in patients with parenchymal lung disease. Because CT is commonly used to evaluate parenchymal lung disease, this information is readily available.
Key Words: computed tomography • interstitial lung disease • pulmonary hypertension
This article has been cited by other articles:
|
|
 |
|
  H. Chen, T. De Marco, J. A. Golden, M. K. Gould, D. A. Zisman, and A. S. Karlamangla Utility of CT for Predicting Pulmonary Hypertension in Patients With Parenchymal Lung Disease: Similar Results, Different Conclusion? Chest, April 1, 2008; 133(4): 1053 - 1054. [Full Text] [PDF]
|
|
|
|
|
|
D. A. Zisman, A. S. Karlamangla, D. J. Ross, M. P. Keane, J. A. Belperio, R. Saggar, J. P. Lynch III, A. Ardehali, and J. Goldin High-Resolution Chest CT Findings Do Not Predict the Presence of Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis Chest, September 1, 2007; 132(3): 773 - 779. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Castaner, X. Gallardo, J. Rimola, Y. Pallardo, J. M. Mata, J. Perendreu, C. Martin, and D. Gil Congenital and acquired pulmonary artery anomalies in the adult: radiologic overview. RadioGraphics, March 1, 2006; 26(2): 349 - 371. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Heinrich, M. Uder, D. Tscholl, A. Grgic, B. Kramann, and H.-J. Schafers CT Scan Findings in Chronic Thromboembolic Pulmonary Hypertension: Predictors of Hemodynamic Improvement After Pulmonary Thromboendarterectomy Chest, May 1, 2005; 127(5): 1606 - 1613. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Remy-Jardin, A. Duhamel, V. Deken, N. Bouaziz, P. Dumont, and J. Remy Systemic Collateral Supply in Patients with Chronic Thromboembolic and Primary Pulmonary Hypertension: Assessment with Multi-Detector Row Helical CT Angiography Radiology, April 1, 2005; 235(1): 274 - 281. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Matsuoka, K. Uchiyama, H. Shima, N. Ueno, S. Oish, and Y. Nojiri Bronchoarterial Ratio and Bronchial Wall Thickness on High-Resolution CT in Asymptomatic Subjects: Correlation with Age and Smoking Am. J. Roentgenol., February 1, 2003; 180(2): 513 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Hansell Small-Vessel Diseases of the Lung: CT-Pathologic Correlates Radiology, December 1, 2002; 225(3): 639 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Engelke, C. Schaefer-Prokop, E. Schirg, J. Freihorst, S. Grubnic, and M. Prokop High-Resolution CT and CT Angiography of Peripheral Pulmonary Vascular Disorders RadioGraphics, July 1, 2002; 22(4): 739 - 764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. N. Bugnone, M. Viamonte Jr, and H. Garcia Imaging Findings in Human Immunodeficiency Virus-related Pulmonary Hypertension: Report of Five Cases and Review of the Literature Radiology, June 1, 2002; 223(3): 820 - 827. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Frazier, J. R. Galvin, T. J. Franks, and M. L. Rosado-de-Christenson From the Archives of the AFIP : Pulmonary Vasculature: Hypertension and Infarction (CME available in print version and on RSNA Link) RadioGraphics, March 1, 2000; 20(2): 491 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Remy-Jardin and J. Remy Spiral CT Angiography of the Pulmonary Circulation Radiology, September 1, 1999; 212(3): 615 - 636. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
