Schmidt H C, Kauczor H U, Schild H H, Renner C, Kirchhoff E, Lang P, Iversen S, Thelen M
Department of Radiology, University Hospital, Mainz, Germany.
Eur Radiol. 1996;6(6):817-25. doi: 10.1007/BF00240678.
The purpose of this study was to assess the value of morphometric data on conventional radiography and CT predicting the presence and degree of pulmonary hypertension and to assess the reversibility after surgery. On preoperative X-ray films and CT scans of 50 patients with pulmonary hypertension secondary to chronic thromboembolism, we measured the cardiothoracic ratio, basal diameter, length of cardiac contact to sternum, pulmonary trunk, right and left descending pulmonary artery, and the septum angle. These data were correlated with pulmonary arterial pressure. In 14 X-ray patients and 18 CT patients, with follow-up after surgical thromboendarterectomy the reversibility of these changes was assessed. A dilated pulmonary trunk was the most common abnormality (96% each on X-ray and CT). Pulmonary arteries were dilated on X-ray in 40% (right) and 14% (left), and on CT in 92% (right) and 96% (left). The best correlation with mean arterial pressure was found measuring the pulmonary trunk on CT (r = 0.43, p < 0.01). After surgery, reversibility was most significant for the pulmonary trunk on CT (p < 0.0001). In patients with chronic pulmonary embolism, pulmonary hypertension can best be predicted by assessing the diameter of the pulmonary trunk both on X-ray and CT. No close correlation is present between the extent of any parameter and the level of pulmonary pressure.
本研究的目的是评估传统X线摄影和CT上的形态学数据对预测肺动脉高压的存在及程度的价值，并评估手术后的可逆性。对50例慢性血栓栓塞性肺动脉高压患者的术前X线片和CT扫描，我们测量了心胸比率、基底径、心脏与胸骨接触长度、肺动脉主干、左右肺动脉降支以及间隔角。这些数据与肺动脉压相关。在14例X线检查患者和18例CT检查患者中，手术血栓内膜剥脱术后进行随访，评估这些变化的可逆性。肺动脉主干扩张是最常见的异常（X线和CT上均为96%）。X线显示40%（右侧）和14%（左侧）肺动脉扩张，CT显示92%（右侧）和96%（左侧）肺动脉扩张。在CT上测量肺动脉主干与平均动脉压的相关性最佳（r = 0.43，p < 0.01）。手术后，CT上肺动脉主干的可逆性最为显著（p < 0.0001）。在慢性肺栓塞患者中，通过评估X线和CT上肺动脉主干的直径可以最好地预测肺动脉高压。任何参数的范围与肺动脉压水平之间均无密切相关性。
