Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.

PURPOSE:Hepatopulmonary syndrome (HPS) is defined as an arterial oxygenation defect induced by intrapulmonary vascular dilatations associated with hepatic disease. This study aimed to assess the prevalence of type 1 and 2 pulmonary vascular abnormalities on chest computed tomography (CT) in patients...

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Main Authors: Luciano Folador, Felipe S Torres, Juliana F Zampieri, Betina C Machado, Marli M Knorst, Marcelo B Gazzana
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0223805
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author Luciano Folador
Felipe S Torres
Juliana F Zampieri
Betina C Machado
Marli M Knorst
Marcelo B Gazzana
author_facet Luciano Folador
Felipe S Torres
Juliana F Zampieri
Betina C Machado
Marli M Knorst
Marcelo B Gazzana
author_sort Luciano Folador
collection DOAJ
description PURPOSE:Hepatopulmonary syndrome (HPS) is defined as an arterial oxygenation defect induced by intrapulmonary vascular dilatations associated with hepatic disease. This study aimed to assess the prevalence of type 1 and 2 pulmonary vascular abnormalities on chest computed tomography (CT) in patients with cirrhosis and HPS and to characterize intra- and interobserver reliability. MATERIALS AND METHODS:Two thoracic radiologists retrospectively evaluated chest CT scans from 38 cirrhosis patients with HPS. They classified the pulmonary vascular abnormalities as type 1 (multiple dilated distal pulmonary arteries), type 2(nodular dilatation or individual pulmonary arterial malformation), or absence of abnormality. Furthermore, they measured the diameters of the central pulmonary arteries and subsegmental pulmonary arteries and bronchi. We analyzed the prevalence, intraobserver reliability, and interobserver reliability of abnormal CT findings related to HPS, and the correlation of these findings with partial arterial oxygen pressure (PaO2). RESULTS:The overall prevalence of pulmonary vascular abnormalities was 28.9% (95% confidence intervals: 15.4%, 45.9%). Moreover, 26.3% of patients had type 1 abnormality (13.4%, 43.1%) and 2.6% of patients had type 2 abnormality (0.0%, 13.8%). The intraobserver reliability kappa value was 0.666 (0.40, 0.91) and the interobserver kappa value was 0.443 (0.12, 0.77). There was no correlation between pulmonary vascular abnormalities on CT and PaO2 values. CONCLUSIONS:The prevalence of pulmonary vascular abnormalities on chest CT of patients with cirrhosis and HPS is low and not correlated with PaO2. These findings question the usefulness of chest CT for the evaluation of patients with cirrhosis and HPS.
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spelling doaj.art-873e25f572ab49b8a10e135852a0c4062022-12-21T21:55:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011410e022380510.1371/journal.pone.0223805Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.Luciano FoladorFelipe S TorresJuliana F ZampieriBetina C MachadoMarli M KnorstMarcelo B GazzanaPURPOSE:Hepatopulmonary syndrome (HPS) is defined as an arterial oxygenation defect induced by intrapulmonary vascular dilatations associated with hepatic disease. This study aimed to assess the prevalence of type 1 and 2 pulmonary vascular abnormalities on chest computed tomography (CT) in patients with cirrhosis and HPS and to characterize intra- and interobserver reliability. MATERIALS AND METHODS:Two thoracic radiologists retrospectively evaluated chest CT scans from 38 cirrhosis patients with HPS. They classified the pulmonary vascular abnormalities as type 1 (multiple dilated distal pulmonary arteries), type 2(nodular dilatation or individual pulmonary arterial malformation), or absence of abnormality. Furthermore, they measured the diameters of the central pulmonary arteries and subsegmental pulmonary arteries and bronchi. We analyzed the prevalence, intraobserver reliability, and interobserver reliability of abnormal CT findings related to HPS, and the correlation of these findings with partial arterial oxygen pressure (PaO2). RESULTS:The overall prevalence of pulmonary vascular abnormalities was 28.9% (95% confidence intervals: 15.4%, 45.9%). Moreover, 26.3% of patients had type 1 abnormality (13.4%, 43.1%) and 2.6% of patients had type 2 abnormality (0.0%, 13.8%). The intraobserver reliability kappa value was 0.666 (0.40, 0.91) and the interobserver kappa value was 0.443 (0.12, 0.77). There was no correlation between pulmonary vascular abnormalities on CT and PaO2 values. CONCLUSIONS:The prevalence of pulmonary vascular abnormalities on chest CT of patients with cirrhosis and HPS is low and not correlated with PaO2. These findings question the usefulness of chest CT for the evaluation of patients with cirrhosis and HPS.https://doi.org/10.1371/journal.pone.0223805
spellingShingle Luciano Folador
Felipe S Torres
Juliana F Zampieri
Betina C Machado
Marli M Knorst
Marcelo B Gazzana
Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
PLoS ONE
title Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
title_full Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
title_fullStr Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
title_full_unstemmed Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
title_short Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography.
title_sort hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography
url https://doi.org/10.1371/journal.pone.0223805
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