Abozeed Mostafa, Conic Sofija, Bullen Jennifer, Rizk Alain, Saeedan Mnahi Bin, Karim Wadih, Heresi Gustavo A, Renapurkar Rahul D
Sections of Thoracic and Cardiovascular Imaging Laboratory, Imaging Institute, Cleveland Clinic, OH, USA.
Quantitative Health Sciences, Cleveland Clinic, OH, USA.
Cardiovasc Diagn Ther. 2022 Jun;12(3):305-313. doi: 10.21037/cdt-21-686.
We used a dual energy computed tomography (DECT) based scoring system in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and correlated it with functional and hemodynamic parameters.
This was a retrospective study on 78 patients with CTEPH who underwent DECT. First, clot burden score was calculated by assigning a following score: pulmonary trunk-5, each main pulmonary artery-4, each lobar-3, each segmental-2, and subsegmental-1 per lobe; sum total was then calculated. Perfusion defect (PD) score was calculated by assigning 1 point to each segmental PD. Combined score was calculated by adding the clot burden and PD score. All three scores were correlated with clinical and hemodynamic parameters that included New York Heart Association (NYHA) functional class, 6-minute walk distance (6MWT) in feet, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), pulmonary arterial pressure (PAP) [systolic PAP (sPAP), diastolic PAP (dPAP) and mean PAP (mPAP)], pulmonary vascular resistance (PVR), right atrial pressure, cardiac output, and cardiac index.
Clot burden score, PD score, and combined score all positively correlated with sPAP (0.25, 0.34, 0.34), PVR (0.27, 0.30, 0.34), and mPAP (0.28, 0.31, 0.36). There was no statistically significant correlation of clot burden score, PD score and combined score with 6MWT, % predicted 6MWT, FEV1, FEV1%, FVC, FVC%, DLCO% and NYHA functional class.
DECT based scoring in CTEPH is feasible and correlates positively with sPAP, mPAP and PVR. Combined score has the highest magnitude of correlation.
我们在慢性血栓栓塞性肺动脉高压（CTEPH）患者中使用了基于双能量计算机断层扫描（DECT）的评分系统，并将其与功能和血流动力学参数相关联。
这是一项对78例接受DECT检查的CTEPH患者的回顾性研究。首先，通过赋予以下分数来计算血栓负荷评分：肺动脉主干-5分，每条主肺动脉-4分，每个叶-3分，每个节段-2分，每个亚节段-1分；然后计算总分。灌注缺损（PD）评分通过为每个节段性PD赋予1分来计算。综合评分通过将血栓负荷和PD评分相加来计算。所有这三个评分均与临床和血流动力学参数相关，这些参数包括纽约心脏协会（NYHA）功能分级、以英尺为单位的6分钟步行距离（6MWT）、一秒用力呼气量（FEV1）、用力肺活量（FVC）、肺一氧化碳弥散量（DLCO）、肺动脉压（PAP）[收缩期PAP（sPAP）、舒张期PAP（dPAP）和平均PAP（mPAP）]、肺血管阻力（PVR）、右心房压力、心输出量和心脏指数。
血栓负荷评分、PD评分和综合评分均与sPAP（0.25、0.34、0.34）、PVR（0.27、0.30、0.34）和mPAP（0.28、0.31、0.36）呈正相关。血栓负荷评分、PD评分和综合评分与6MWT、预测的6MWT百分比、FEV1、FEV1%、FVC、FVC%、DLCO%和NYHA功能分级之间无统计学显著相关性。
CTEPH中基于DECT的评分是可行的，并且与sPAP、mPAP和PVR呈正相关。综合评分的相关性最高。
