Burakowska Barbara, Pawlicka Lilia, Oniszh Karina, Burakowski Janusz, Kurzyna Marcin, Kober Jarosław, Fijałkowska Anna, Hajduk Bogdan, Tomkowski Witold, Bestry Iwona, Torbicki Adam
Zakład Radiologii Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Pol Arch Med Wewn. 2004 Apr;111(4):431-41.
Pulmonary hypertension (PH) represents an important diagnostic problem, because of its non-specific clinical presentation.
Estimation of sensitivity and specificity of spiral computed tomography (SCT) in diagnosis of PH. Estimation of the influence of the cause and character of PH on morphology of pulmonary arteries and right ventricle-pulmonary artery coupling.
102 patients with clinical suspicion of acute pulmonary embolism (APE) or chronic PH (54F, av. age 51.3 +/- 17.3). Diameters of pulmonary arteries obtained in SCT, systolic pulmonary pressure calculated from the tricuspid gradient pressure, and indices of the right ventricle-pulmonary artery dynamical coupling (AcT) obtained from the echo-Doppler method were compared.
Increased diameter (> 18 mm) of interlobar arteries was the most specific sign of PH (specificity 92%, sensitivity 45%). Diameter of proximal pulmonary arteries and pulmonary pressure was correlated in patients with APE (r = 0.487, p < 0.003), but not in those with chronic PH (r = 0.223). In a group of patients with pulmonary arterial hypertension (PAH), enlargement of proximal pulmonary arteries seemed to result in less disturbed right ventricle-pulmonary artery dynamic coupling.
肺动脉高压（PH）因其临床表现不具特异性，是一个重要的诊断难题。
评估螺旋计算机断层扫描（SCT）在诊断PH中的敏感性和特异性。评估PH的病因和特征对肺动脉形态及右心室 - 肺动脉耦合的影响。
102例临床怀疑急性肺栓塞（APE）或慢性PH的患者（54例女性，平均年龄51.3±17.3岁）。比较SCT测得的肺动脉直径、根据三尖瓣梯度压力计算的收缩期肺动脉压以及通过超声多普勒法获得的右心室 - 肺动脉动态耦合指数（AcT）。
叶间动脉直径增大（>18mm）是PH最具特异性的征象（特异性92%，敏感性45%）。APE患者近端肺动脉直径与肺动脉压相关（r = 0.487，p < 0.003），而慢性PH患者则无相关性（r = 0.223）。在一组肺动脉高压（PAH）患者中，近端肺动脉扩张似乎导致右心室 - 肺动脉动态耦合受干扰程度较小。
