Dual-energy computed tomography in the assessment of vascular and parenchymal enhancement in suspected pulmonary hypertension.
J Thorac Imaging
; 29(2): 98-106, 2014 Mar.
Article
em En
| MEDLINE
| ID: mdl-24247086
ABSTRACT
PURPOSE:
To evaluate quantitative differences in central pulmonary artery (PA) and pulmonary global and regional enhancement in patients with and without pulmonary hypertension (PH) using dual-energy computed tomography (DECT). MATERIALS ANDMETHODS:
We retrospectively studied 391 thoracic DECT studies and identified 89 patients with PA pressure (PAP) data and a pulmonary angiogram. PH was defined as a mean PAP of ≥25 mm Hg on right heart catheterization (RHC) (n=19) or a systolic PAP of ≥40 mm Hg on echocardiography (n=20). PH absence was defined by entirely normal echocardiography or RHC (n=50). PA enhancement (PAenh) was calculated from DECT iodine images. Volumetric enhancement of each whole lung (WLenh), 6 standard lung regions (RLenh), and 24 two-dimensional standardized regions of interest (ROIenh) was performed in each patient using pulmonary blood volume analysis.RESULTS:
Mean PAenh was greater in PH patients compared with controls (272 vs. 252 HU, P<0.05), with a reciprocal reduction in mean WLenh (27 vs. 32 HU, P<0.01). Mean ROIenh (n=2058) confirmed lower parenchymal enhancement in PH (27 vs. 32 HU, P<0.001), with greater mean ROIenh standard deviation (10.5 vs. 9.3, P<0.001). Mean intrapatient pulmonary enhancement variability was greater in PH patients than in controls for 6 RLenh (variance 37 vs. 22, P=0.02) and 24 ROIenh measures (variance 188 vs. 130, P=0.04). RLenh and ROIenh variance correlated with RHC pulmonary vascular resistance (PVR) (r=0.44, 0.48; P=0.04, 0.03, respectively). A ratio of PAenh/WLenh distinguished PH from non-PH patients (10.9 vs. 8.4, P<0.001) and correlated best with PVR (r=0.59, P=0.004).CONCLUSIONS:
PH patients demonstrate increased PAenh with a reciprocal reduction and greater variation in parenchymal enhancement; a DECT ratio of central to parenchymal enhancement correlates with PVR and may help identify PH.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artéria Pulmonar
/
Tomografia Computadorizada por Raios X
/
Hipertensão Pulmonar
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Thorac Imaging
Assunto da revista:
DIAGNOSTICO POR IMAGEM
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Reino Unido