Cargando…

Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension

BACKGROUND: On high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertensi...

Descripción completa

Detalles Bibliográficos
Autores principales: Ratanawatkul, Pailin, Oh, Andrea, Richards, J. Caleb, Swigris, Jeffrey J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008140/
https://www.ncbi.nlm.nih.gov/pubmed/32055634
http://dx.doi.org/10.1183/23120541.00232-2019
_version_ 1783495424202506240
author Ratanawatkul, Pailin
Oh, Andrea
Richards, J. Caleb
Swigris, Jeffrey J.
author_facet Ratanawatkul, Pailin
Oh, Andrea
Richards, J. Caleb
Swigris, Jeffrey J.
author_sort Ratanawatkul, Pailin
collection PubMed
description BACKGROUND: On high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension. METHODS: We retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). RESULTS: Of 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PA:Ao) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PA:Ao was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PA:Ao, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= −0.24). CONCLUSIONS: Findings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PA:Ao ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PA:Ao had higher specificity in COPD.
format Online
Article
Text
id pubmed-7008140
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher European Respiratory Society
record_format MEDLINE/PubMed
spelling pubmed-70081402020-02-13 Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension Ratanawatkul, Pailin Oh, Andrea Richards, J. Caleb Swigris, Jeffrey J. ERJ Open Res Original Articles BACKGROUND: On high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension. METHODS: We retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). RESULTS: Of 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PA:Ao) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PA:Ao was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PA:Ao, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= −0.24). CONCLUSIONS: Findings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PA:Ao ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PA:Ao had higher specificity in COPD. European Respiratory Society 2020-02-10 /pmc/articles/PMC7008140/ /pubmed/32055634 http://dx.doi.org/10.1183/23120541.00232-2019 Text en Copyright ©ERS 2020 http://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Original Articles
Ratanawatkul, Pailin
Oh, Andrea
Richards, J. Caleb
Swigris, Jeffrey J.
Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title_full Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title_fullStr Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title_full_unstemmed Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title_short Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
title_sort performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008140/
https://www.ncbi.nlm.nih.gov/pubmed/32055634
http://dx.doi.org/10.1183/23120541.00232-2019
work_keys_str_mv AT ratanawatkulpailin performanceofpulmonaryarterydimensionsmeasuredonhighresolutioncomputedtomographyscanforidentifyingpulmonaryhypertension
AT ohandrea performanceofpulmonaryarterydimensionsmeasuredonhighresolutioncomputedtomographyscanforidentifyingpulmonaryhypertension
AT richardsjcaleb performanceofpulmonaryarterydimensionsmeasuredonhighresolutioncomputedtomographyscanforidentifyingpulmonaryhypertension
AT swigrisjeffreyj performanceofpulmonaryarterydimensionsmeasuredonhighresolutioncomputedtomographyscanforidentifyingpulmonaryhypertension