Novel computed tomographic chest metrics to detect pulmonary hypertension

<p>Abstract</p> <p>Background</p> <p>Early diagnosis of pulmonary hypertension (PH) can potentially improve survival and quality of life. Detecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right heart catheterizati...

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Main Authors: Li Chin-Shang, MacDonald Taylor, Shelton David K, Juarez Maya M, Chan Andrew L, Lin Tzu-Chun, Albertson Timothy E
Format: Article
Language:English
Published: BMC 2011-03-01
Series:BMC Medical Imaging
Online Access:http://www.biomedcentral.com/1471-2342/11/7
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author Li Chin-Shang
MacDonald Taylor
Shelton David K
Juarez Maya M
Chan Andrew L
Lin Tzu-Chun
Albertson Timothy E
author_facet Li Chin-Shang
MacDonald Taylor
Shelton David K
Juarez Maya M
Chan Andrew L
Lin Tzu-Chun
Albertson Timothy E
author_sort Li Chin-Shang
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Early diagnosis of pulmonary hypertension (PH) can potentially improve survival and quality of life. Detecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right heart catheterization (RHC) for the diagnosis of PH adds risk and expense due to its invasive nature. Pre-defined measurements utilizing computed tomography (CT) of the chest may be an alternative non-invasive method of detecting PH.</p> <p>Methods</p> <p>This study retrospectively reviewed 101 acutely hospitalized inpatients with heterogeneous diagnoses, who consecutively underwent CT chest and RHC during the same admission. Two separate teams, each consisting of a radiologist and pulmonologist, blinded to clinical and RHC data, individually reviewed the chest CT's.</p> <p>Results</p> <p>Multiple regression analyses controlling for age, sex, ascending aortic diameter, body surface area, thoracic diameter and pulmonary wedge pressure showed that a main pulmonary artery (PA) diameter ≥29 mm (odds ratio (OR) = 4.8), right descending PA diameter ≥19 mm (OR = 7.0), true right descending PA diameter ≥ 16 mm (OR = 4.1), true left descending PA diameter ≥ 21 mm (OR = 15.5), right ventricular (RV) free wall ≥ 6 mm (OR = 30.5), RV wall/left ventricular (LV) wall ratio ≥0.32 (OR = 8.8), RV/LV lumen ratio ≥1.28 (OR = 28.8), main PA/ascending aorta ratio ≥0.84 (OR = 6.0) and main PA/descending aorta ratio ≥ 1.29 (OR = 5.7) were significant predictors of PH in this population of hospitalized patients.</p> <p>Conclusion</p> <p>This combination of easily measured CT-based metrics may, upon confirmatory studies, aid in the non-invasive detection of PH and hence in the determination of RHC candidacy in acutely hospitalized patients.</p>
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spelling doaj.art-2ceeb72065bf44bdbff1a456d897df7e2022-12-22T03:10:54ZengBMCBMC Medical Imaging1471-23422011-03-01111710.1186/1471-2342-11-7Novel computed tomographic chest metrics to detect pulmonary hypertensionLi Chin-ShangMacDonald TaylorShelton David KJuarez Maya MChan Andrew LLin Tzu-ChunAlbertson Timothy E<p>Abstract</p> <p>Background</p> <p>Early diagnosis of pulmonary hypertension (PH) can potentially improve survival and quality of life. Detecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right heart catheterization (RHC) for the diagnosis of PH adds risk and expense due to its invasive nature. Pre-defined measurements utilizing computed tomography (CT) of the chest may be an alternative non-invasive method of detecting PH.</p> <p>Methods</p> <p>This study retrospectively reviewed 101 acutely hospitalized inpatients with heterogeneous diagnoses, who consecutively underwent CT chest and RHC during the same admission. Two separate teams, each consisting of a radiologist and pulmonologist, blinded to clinical and RHC data, individually reviewed the chest CT's.</p> <p>Results</p> <p>Multiple regression analyses controlling for age, sex, ascending aortic diameter, body surface area, thoracic diameter and pulmonary wedge pressure showed that a main pulmonary artery (PA) diameter ≥29 mm (odds ratio (OR) = 4.8), right descending PA diameter ≥19 mm (OR = 7.0), true right descending PA diameter ≥ 16 mm (OR = 4.1), true left descending PA diameter ≥ 21 mm (OR = 15.5), right ventricular (RV) free wall ≥ 6 mm (OR = 30.5), RV wall/left ventricular (LV) wall ratio ≥0.32 (OR = 8.8), RV/LV lumen ratio ≥1.28 (OR = 28.8), main PA/ascending aorta ratio ≥0.84 (OR = 6.0) and main PA/descending aorta ratio ≥ 1.29 (OR = 5.7) were significant predictors of PH in this population of hospitalized patients.</p> <p>Conclusion</p> <p>This combination of easily measured CT-based metrics may, upon confirmatory studies, aid in the non-invasive detection of PH and hence in the determination of RHC candidacy in acutely hospitalized patients.</p>http://www.biomedcentral.com/1471-2342/11/7
spellingShingle Li Chin-Shang
MacDonald Taylor
Shelton David K
Juarez Maya M
Chan Andrew L
Lin Tzu-Chun
Albertson Timothy E
Novel computed tomographic chest metrics to detect pulmonary hypertension
BMC Medical Imaging
title Novel computed tomographic chest metrics to detect pulmonary hypertension
title_full Novel computed tomographic chest metrics to detect pulmonary hypertension
title_fullStr Novel computed tomographic chest metrics to detect pulmonary hypertension
title_full_unstemmed Novel computed tomographic chest metrics to detect pulmonary hypertension
title_short Novel computed tomographic chest metrics to detect pulmonary hypertension
title_sort novel computed tomographic chest metrics to detect pulmonary hypertension
url http://www.biomedcentral.com/1471-2342/11/7
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