利用三维心胸 CT 计算中心至外周肺血管容积比预测先天性心脏病患者的肺动脉高压。
Prediction of pulmonary hypertension using central-to-peripheral pulmonary vascular volume ratio on three-dimensional cardiothoracic CT in patients with congenital heart disease.
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
出版信息
Jpn J Radiol. 2022 Sep;40(9):961-969. doi: 10.1007/s11604-022-01272-3. Epub 2022 Mar 31.
PURPOSE
To evaluate whether the central-to-peripheral pulmonary vascular volume ratio measured using three-dimensional cardiothoracic CT can serve as a potential predictor of pulmonary hypertension (PH) in patients with congenital heart disease.
METHODS
Cardiothoracic CT was used to quantify right and left total, central, and peripheral pulmonary vascular volumes segmented based on a three-dimensional threshold-based approach in 60 patients with congenital heart disease (group with PH, n = 30; group without PH, n = 30). The CT-based central-to-peripheral pulmonary vascular volume ratios were correlated with the echocardiography-based maximum velocity of tricuspid regurgitation (TR Vmax) and systolic pulmonary arterial pressure (PAP) values. The diagnostic ability of the central-to-peripheral pulmonary vascular volume ratio to predict PH was analyzed.
RESULTS
The central-to-peripheral pulmonary vascular volume ratios were significantly higher in the group with PH compared to the group without PH (1.6 ± 0.9 vs. 0.8 ± 0.3 for the right side, p < 0.001; 2.4 ± 2.2 vs. 1.0 ± 1.4 for the left side, p < 0.004). The right central-to-peripheral pulmonary volume ratios were significantly positively correlated with the TR Vmax and estimated systolic PAP values (R = 0.627 and 0.633, respectively; p < 0.001) in patients with and without PH, while the ratios were moderately correlated with the TR Vmax and estimated systolic PAP values (R = 0.431 and 0.435, respectively; p < 0.020) in the group with PH. The right and left central-to-peripheral pulmonary vascular volume ratios demonstrated a good diagnostic ability for predicting the presence of PH (area under the receiver-operating characteristic curve = 0.867, p < 0.001 and 0.859, p < 0.001 for the right and left, respectively).
CONCLUSION
The CT-based central-to-peripheral pulmonary vascular volume ratio can be used to predict PH in patients with congenital heart disease.
目的
评估使用三维心胸 CT 测量的中心至外周肺血管容积比是否可作为先天性心脏病患者肺动脉高压（PH）的潜在预测指标。
方法
对 60 例先天性心脏病患者（PH 组 30 例，无 PH 组 30 例）进行心胸 CT 检查，采用基于三维阈值的方法对右心和左心总、中心和外周肺血管容积进行定量分析。将 CT 基础上的中心至外周肺血管容积比与超声心动图最大三尖瓣反流速度（TR Vmax）和收缩期肺动脉压（PAP）值相关联。分析中心至外周肺血管容积比预测 PH 的诊断能力。
结果
PH 组的中心至外周肺血管容积比明显高于无 PH 组（右侧 1.6±0.9 比 0.8±0.3，p<0.001；左侧 2.4±2.2 比 1.0±1.4，p<0.004）。PH 患者和无 PH 患者的右心中心至外周肺容积比与 TR Vmax 和估计的收缩期 PAP 值均呈显著正相关（R 分别为 0.627 和 0.633，p<0.001），而在 PH 组中，比值与 TR Vmax 和估计的收缩期 PAP 值中度相关（R 分别为 0.431 和 0.435，p<0.020）。右心和左心中心至外周肺血管容积比对预测 PH 的存在具有良好的诊断能力（右心和左心受试者工作特征曲线下面积分别为 0.867、p<0.001 和 0.859、p<0.001）。
结论
CT 基础上的中心至外周肺血管容积比可用于预测先天性心脏病患者的 PH。
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