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Performance of computed tomography-derived pulmonary vasculature metrics in the diagnosis and haemodynamic assessment of pulmonary arterial hypertension

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Title: Performance of computed tomography-derived pulmonary vasculature metrics in the diagnosis and haemodynamic assessment of pulmonary arterial hypertension
Authors: Shimizu, Kaoruko Browse this author →KAKEN DB
Tsujino, Ichizo Browse this author →KAKEN DB
Sato, Takahiro Browse this author
Sugimoto, Ayako Browse this author
Nakaya, Toshitaka Browse this author
Watanabe, Taku Browse this author →KAKEN DB
Ohira, Hiroshi Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author →KAKEN DB
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: Pulmonary arterial hypertension
Pulmonary vasculature
Pulmonary vein
Computed tomography (CT)
Haemodynamic assessment
Issue Date: Nov-2017
Publisher: Elsevier
Journal Title: European journal of radiology
Volume: 96
Start Page: 31
End Page: 38
Publisher DOI: 10.1016/j.ejrad.2017.09.010
PMID: 29103472
Abstract: Background: Few studies have addressed the value of combining computed tomography-derived pulmonary vasculature metrics for the diagnosis and haemodynamic evaluation of pulmonary arterial hypertension (PAH). Materials and methods: We measured three computed tomography parameters for the pulmonary artery, peripheral vessels, and pulmonary veins: the ratio of the diameter of the pulmonary artery to the aorta (PA/Ao), the cross-sectional area of small pulmonary vessels <5 mm2 as a percentage of total lung area (%CSA<5), and the diameter of the right inferior pulmonary vein (PVD). The measured quantities were compared between patients with PAH (n = 45) and control subjects (n = 56), and their diagnostic performance and associations with PAH-related clinical indices, including right heart catheterization measurements, were examined. Results: PA/Ao and %CSA<5 were significantly higher in patients with PAH than in controls. Receiver-operating characteristic curve analysis for ability to diagnose PAH showed a high area under the curve (AUC) for PA/Ao (0.95) and modest AUCs for %CSA<5 (0.75) and PVD (0.56). PA/Ao correlated positively with mean pulmonary arterial pressure and PVD correlated negatively with pulmonary vascular resistance. The %CSA<5 correlated negatively with mean pulmonary arterial pressure and pulmonary vascular resistance and positively with cardiac index. Notably, the PA/Ao and PVD values divided by %CSA<5 correlated better with right heart catheterization indices than the non-divided values. Conclusion: PA/Ao, %CSA<5, and PVD are useful non-invasive pulmonary vasculature metrics, both alone and in combination, for diagnosis and haemodynamic assessment of PAH.
Rights: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 薫子

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