Right pulmonary artery distensibility measured by ECG-gated 64-section CT demonstrated excellent diagnostic value for pulmonary hypertension (AUC 0.951; 95% CI 0.89-1).
Cross-Sectional (n=45)
Do functional parameters measured by ECG-gated 64-section CT accurately diagnose pulmonary hypertension in patients undergoing diagnostic work-up?
Right pulmonary artery distensibility measured by ECG-gated 64-section CT provides excellent diagnostic value for pulmonary hypertension and correlates strongly with invasive mean pulmonary arterial pressure.
Effect estimate: AUC 0.951 (95% CI 0.89-1)
p-value: p=<.0001
PURPOSE: To evaluate, by using electrocardiographically (ECG)-gated multidetector computed tomography (CT), parameters such as right ventricular outflow tract (RVOT) systolic shortening and myocardial thickness and right pulmonary artery (RPA) distensibility, reported to be abnormal at echocardiography and/or magnetic resonance (MR) imaging in patients with pulmonary hypertension (PHT). MATERIALS AND METHODS: The institutional review board approved the study and waived informed consent. Forty-five patients, 21 with PHT (group 1; mean pulmonary arterial pressure PAP, 42 mm Hg) and 24 without (group 2; mean PAP, 16.5 mm Hg), who had undergone thoracic ECG-gated 64-section CT and right heart catheterization as part of their diagnostic work-up were included in this study. Two independent observers measured RPA distensibility and RVOT myocardial thickness, diameter, and cross-sectional area during systole and diastole. Their values were compared in both groups (Mann-Whitney U test). The area under the receiver operating characteristic (ROC) curve and Spearman correlation with mean PAP were also obtained. RESULTS: Interobserver agreement was good for all measurements (R > 0.8) except for systolic RVOT wall thickness. Median values of RPA distensibility, diastolic RVOT wall thickness, and systolic RVOT diameter and cross-sectional area were significantly different between groups 1 and 2. The largest area under the ROC curve was obtained with RPA distensibility (0.951; 95% confidence interval: 0.89, 1) also showing the closest correlation with mean PAP (r = -0.79; P < .0001). CONCLUSION: Among all parameters evaluated, RPA distensibility shows the best diagnostic value for PHT and could be useful for risk stratification.
Revel et al. (Sun,) conducted a cross-sectional in Pulmonary hypertension (n=45). ECG-gated 64-section CT (RPA distensibility) vs. Patients without pulmonary hypertension was evaluated on Diagnostic value for pulmonary hypertension (Area under the ROC curve) (AUC 0.951, 95% CI 0.89-1, p=<.0001). Right pulmonary artery distensibility measured by ECG-gated 64-section CT demonstrated excellent diagnostic value for pulmonary hypertension (AUC 0.951; 95% CI 0.89-1).