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The aim of this study was to determine whether the ratio of the diameters of the main pulmonary artery and of the ascending aorta (rPA), as assessed on computed tomography (CT), is predictive of pulmonary arterial hypertension (PAH). We undertook a retrospective review of 50 patients with a wide range of pulmonary and cardiovascular diseases, who had undergone both chest CT and pulmonary arterial pressure measurements at right heart catheterization. Two independent observers made measurements of the diameter of the main pulmonary artery and of the ascending aorta on a single defined CT section. Body surface area (BSA, n = 48), pulmonary arteriolar resistance (n = 39), total lung capacity (n = 40), and aortic pressures (n = 50) were also recorded. rPA and pulmonary arterial diameter (dPA) were positively related to mean pulmonary artery pressure (Rs = 0.74, p 1, the sensitivity, specificity, and positive and negative predictive values for determining PAH were 70% (26/37), 92% (12/13), 96% (26/27), and 52% (12/23), respectively. On multivariate analysis, rPA was positively related to mean pulmonary artery pressure (p 1" is simple in practical CT reading to determine; if this is identified, there is a very high probability of pulmonary arterial hypertension, and clinicians should be alerted to this possibility.
Ng et al. (Fri,) studied this question.