Katikireddy Chandra K, Singh Manmeet, Muhyieddeen Kamil, Acharya Tushar, Ambrose John A, Samim Arang
Cardiovascular Division, VA Central California Health System, Fresno, 2615 E Clinton Ave, CA 93703, USA; UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
J Cardiovasc Comput Tomogr. 2016 May-Jun;10(3):246-50. doi: 10.1016/j.jcct.2016.01.014. Epub 2016 Jan 30.
It is unknown whether axial non-gated CT can distinguish World Health Organization Group 2 pulmonary hypertension (pulmonary hypertension due to left heart disease) from non-Group 2 pulmonary hypertension.
The study was performed to identity imaging parameters in non-gated chest CT that differentiate Group 2 from non-Group 2 pulmonary hypertension.
Among 158 patients who underwent right heart catheterization for evaluation of pulmonary hypertension, 112 had sufficient data and chest CT for review. Invasive hemodynamic data and numerous variables obtained from axial CT images (maximum diameters of main, right, left pulmonary arteries, ascending aorta, main pulmonary artery to ascending aorta diameter ratio, right atrial diameter, left atrial area and right ventricular size) were collected. CT variables were validated against hemodynamic data to identify parameters that would allow to differentiate pulmonary hypertension due to left heart disease (Group 2) from non-Group 2 pulmonary hypertension.
Based on right heart catheterization data, we identified 53 patients with Group 2 pulmonary hypertension, 50 patients with non-Group 2 pulmonary hypertension, and 9 subjects with no pulmonary hypertension. In patients with a dilated pulmonary artery (n = 84), the ROC curve for left atrial area (area under the ROC curve 0.76 ± 0.06) independently distinguished patients with Group 2 pulmonary hypertension (n = 42) from patients with non-Group 2 pulmonary hypertension (n = 42). A dilated left atrium (>20 mm(2)) in combination with a normal right ventriuclar size had a sensitivity of 77% and specificity of 94% for Group 2 pulmonary hypertension.
In patients with a dilated pulmonary artery on chest CT, left atrial area and right ventricular dimensions may aid to diagnose pulmonary hypertension and to distinguish underlying cardiac disease from other causes.
轴向非门控CT能否区分世界卫生组织第2组肺动脉高压（左心疾病所致肺动脉高压）与非第2组肺动脉高压尚不清楚。
本研究旨在确定非门控胸部CT中能够区分第2组与非第2组肺动脉高压的影像参数。
在158例接受右心导管检查以评估肺动脉高压的患者中，112例有足够的数据和胸部CT可供复查。收集了有创血流动力学数据以及从轴向CT图像中获得的众多变量（主肺动脉、右肺动脉、左肺动脉、升主动脉的最大直径，主肺动脉与升主动脉直径比，右心房直径，左心房面积和右心室大小）。将CT变量与血流动力学数据进行验证，以确定能够区分左心疾病所致肺动脉高压（第2组）与非第2组肺动脉高压的参数。
根据右心导管检查数据，我们确定了53例第2组肺动脉高压患者、50例非第2组肺动脉高压患者和9例无肺动脉高压的受试者。在肺动脉扩张的患者（n = 84）中，左心房面积的ROC曲线（ROC曲线下面积为0.76±0.06）能够独立区分第2组肺动脉高压患者（n = 42）与非第2组肺动脉高压患者（n = 42）。左心房扩张（>20 mm²）且右心室大小正常对第2组肺动脉高压的敏感性为77%，特异性为94%。
对于胸部CT显示肺动脉扩张的患者，左心房面积和右心室大小可能有助于诊断肺动脉高压，并区分潜在的心脏疾病与其他病因。
