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有和无肺动脉高压患者的计算机断层扫描肺动脉容积与肺动脉压力之间的关系

Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension.

作者信息

Froelich Jens J, Koenig Helmut, Knaak Lennard, Krass Stefan, Klose Klaus J

机构信息

Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg, Germany.

出版信息

Eur J Radiol. 2008 Sep;67(3):466-71. doi: 10.1016/j.ejrad.2007.08.022. Epub 2007 Oct 29.

Abstract

OBJECTIVES

This study was designed to determine the relationship between pulmonary artery (PA) volumes at computed tomography (CT) and PA pressures at right-sided heart catheterization in patients with and without pulmonary hypertension (PAH) to develop a noninvasive CT method of PA pressure quantification.

MATERIALS AND METHODS

Sixteen patients with chronic sleep apnea syndrome underwent contrast enhanced helical CT (slice thickness 3mm; pitch 2; increment 2mm) at inspiration. Eight patients had PAH while cardiopulmonary disease has been excluded in eight other patients. Vascular volumes were determined using a 3D technique (threshold seeded vascular tracing algorithm; thresholds -600 H [lower] and 3,000 H [upper]). Right-sided heart catheterization measurements were available for linear regression analysis of PA volumes and pressures.

RESULTS

Correlation between PA pressures and volumes (normalized for BMI), was high in both groups (without PAH: r=.85; with PAH .90, Pearson). Compared to elevated PA pressures in patients with pulmonary hypertension (p<.005), PA volumes also were significantly increased (p<.05) among the groups.

CONCLUSIONS

High correlation was found between PA volumes and mean PA pressures in patients with- and without PAH. Significant differences in PA volumes at CT-volumetry may admit non-invasive determination of pulmonary hypertension.

摘要

目的

本研究旨在确定有无肺动脉高压(PAH)患者的计算机断层扫描(CT)肺动脉(PA)容积与右侧心导管检查时PA压力之间的关系,以开发一种无创CT定量PA压力的方法。

材料与方法

16例慢性睡眠呼吸暂停综合征患者在吸气时接受了对比增强螺旋CT检查(层厚3mm;螺距2;增量2mm)。8例患者患有PAH,另外8例患者已排除心肺疾病。使用三维技术(阈值种子血管追踪算法;阈值-600 H[下限]和3000 H[上限])确定血管容积。可获得右侧心导管检查测量值,用于PA容积和压力的线性回归分析。

结果

两组中PA压力与容积(根据BMI标准化)之间的相关性均较高(无PAH组:r = 0.85;有PAH组r = 0.90,Pearson相关性)。与肺动脉高压患者升高的PA压力相比(p < 0.005),两组间PA容积也显著增加(p < 0.05)。

结论

在有和无PAH的患者中,PA容积与平均PA压力之间存在高度相关性。CT容积测量中PA容积的显著差异可能有助于无创诊断肺动脉高压。

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