Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
J Xray Sci Technol. 2022;30(1):185-193. doi: 10.3233/XST-211001.
The morphological alterations of small pulmonary vessels measured by computed tomography (CT) is increasingly used in evaluation of suspected pulmonary hypertension (PH).
To investigate the significance alterations of quantitative assessment of small pulmonary vessels on chest CT in distinguishing different types of PH and their severity.
We retrospectively analyzed a dataset of 120 healthy controls (HCs) and 91 PH patients, including 34 patients with connective tissue diseases-related PH (CTD-PH), 26 patients with idiopathic pulmonary arterial hypertension (iPAH), and 31 patients with chronic obstructive pulmonary disease-related PH (COPD-PH). The CTD-PH patients were divided into mild to moderate PH (CTD-LM-PH) group (n = 17) and severe PH (CTD-S-PH) group (n = 17). A total of 53 CTD patients without PH (CTD-nPH) were enrolled for comparison with the CTD-PH. We measured the cross-sectional area of small pulmonary vessels < 5 mm2 (%CSA <5) and between 5-10 mm2 (%CSA5-10) as a percentage of total lung area among the populations included above and compared %CSA in different types of PH groups and HCs group. The mean pulmonary arterial pressure (mPAP) was measured by right heart catheterization.
The %CSA5-10 of COPD-PH, CTD-PH, and iPAH patients increased (0.21±0.09, 0.49±0.20 and 0.61±0.20, p < 0.02) sequentially, while the %CSA <5 of CTD-PH, iPAH, and COPD-PH patients decreased (0.79±0.65, 0.65±0.38 and 0.52±0.27, p < 0.05) sequentially. The %CSA5-10 was significantly higher in CTD-S-PH patients than CTD-LM-PH patients and CTD-nPH patients (0.51±0.21, 0.31±0.15 and 0.28±0.12, p < 0.01). The %CSA5-10 was positively correlated with mPAP in the CTD-PH group.
The quantitative parameters %CSA <5 and %CSA5-10 assessed by chest CT are useful for distinguishing different types of PH. In addition, the %CSA5-10 can provide information for identification of CTD-PH severity.
计算机断层扫描（CT）测量的小肺血管形态改变越来越多地用于评估疑似肺动脉高压（PH）。
探讨胸部 CT 对小肺血管定量评估在鉴别不同类型 PH 及其严重程度中的意义。
我们回顾性分析了 120 名健康对照者（HCs）和 91 名 PH 患者的数据，包括 34 名结缔组织疾病相关 PH（CTD-PH）患者、26 名特发性肺动脉高压（iPAH）患者和 31 名慢性阻塞性肺疾病相关 PH（COPD-PH）患者。CTD-PH 患者分为轻度至中度 PH（CTD-LM-PH）组（n=17）和重度 PH（CTD-S-PH）组（n=17）。共纳入 53 例无 PH 的 CTD 患者（CTD-nPH）与 CTD-PH 患者进行比较。我们测量了上述人群中小肺血管横截面积＜5mm2（%CSA <5）和 5-10mm2（%CSA5-10）占肺总面积的百分比，并比较了不同类型 PH 组和 HCs 组的%CSA。通过右心导管术测量平均肺动脉压（mPAP）。
COPD-PH、CTD-PH 和 iPAH 患者的%CSA5-10 依次增加（0.21±0.09、0.49±0.20 和 0.61±0.20，p<0.02），而 CTD-PH、iPAH 和 COPD-PH 患者的%CSA <5 依次减少（0.79±0.65、0.65±0.38 和 0.52±0.27，p<0.05）。CTD-S-PH 患者的%CSA5-10 明显高于 CTD-LM-PH 患者和 CTD-nPH 患者（0.51±0.21、0.31±0.15 和 0.28±0.12，p<0.01）。CTD-PH 组%CSA5-10 与 mPAP 呈正相关。
胸部 CT 评估的%CSA <5 和%CSA5-10 定量参数有助于鉴别不同类型的 PH。此外，%CSA5-10 可提供 CTD-PH 严重程度的信息。
