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基于世界卫生组织分类,采用多排螺旋计算机断层扫描检测和鉴别肺动脉高压。

Multidetector computed tomography for detection and characterization of pulmonary hypertension in consideration of WHO classification.

作者信息

Dornia Christian, Lange Tobias J, Behrens Gundula, Stiefel Jaroslava, Müller-Wille René, Poschenrieder Florian, Pfeifer Michael, Leitzmann Michael, Manos Daria, Babar Judith L, Stroszczynski Christian, Hamer Okka W

机构信息

Department of Radiology, University Medical Center Regensburg, Germany.

出版信息

J Comput Assist Tomogr. 2012 Mar-Apr;36(2):175-80. doi: 10.1097/RCT.0b013e31824afbdf.

Abstract

OBJECTIVE

We evaluated the reliability of various multidetector computed tomography (MDCT) parameters for diagnosis and severity assessment of pulmonary hypertension (PH) with consideration of World Health Organization (WHO) classification.

METHODS

A total of 172 patients were included in this retrospective study. One hundred fourteen patients had a diagnosis of PH (mean pulmonary artery pressure ≥25 mm Hg), and 58 patients without PH (mean pulmonary artery pressure <20 mm Hg) served as control subjects. The patients with PH were grouped according to the WHO classification based on PH etiology.

RESULTS

The patients with PH had significantly greater main, left, and right pulmonary artery diameters than the control subjects (P < 0.001). No significant differences within the PH subgroups were found. Receiver operating characteristic analysis showed reasonable sensitivity and specificity for selected MDCT parameters. The severity of PH did not correlate with MDCT parameters.

CONCLUSIONS

Easy-to-determine MDCT parameters allow detection of PH independent of the WHO group. In patients with dilated aorta, the vertebra can be an alternative internal standard. Severity of PH cannot be estimated by MDCT parameters.

摘要

目的

我们评估了各种多排螺旋计算机断层扫描(MDCT)参数在诊断和评估肺动脉高压(PH)严重程度方面的可靠性,并参考了世界卫生组织(WHO)的分类标准。

方法

本回顾性研究共纳入172例患者。其中114例被诊断为PH(平均肺动脉压≥25mmHg),58例无PH(平均肺动脉压<20mmHg)的患者作为对照。PH患者根据WHO基于PH病因的分类进行分组。

结果

PH患者的主肺动脉、左肺动脉和右肺动脉直径明显大于对照组(P<0.001)。在PH亚组中未发现显著差异。受试者工作特征分析显示,所选MDCT参数具有合理的敏感性和特异性。PH的严重程度与MDCT参数无关。

结论

易于确定的MDCT参数可独立于WHO分组检测出PH。在主动脉扩张的患者中,椎体可作为替代的内部标准。MDCT参数无法估计PH的严重程度。

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