Abstract:
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Purpose: The purpose of this study is to describe high-resolusion computed tomography (HRCT) findings in primary pulmonary hypertension (PPH), and to find out their pathological backgrounds.
Methods and Materials: Conventional CT with 5mm thickness and HRCT with 0.5 to 2mm thickness of consecutive 29 patients who met the diagnostic criteria for PPH were evaluated by two independent observers. They evaluated the presence, extent and distribution of various CT findings. Agreement of two observers was analyzed with Kappa statistic. Histopathologic specimens in three patients who underwent unilateral lung transplantation (two patients) or autopsy (one patient) were precisely correlated with corresponding CT findings.
Results: There was excellent agreement between the observers for the detection of CT and HRCT findings (kappa value=0.81). Dilatation of pulmonary artery trunk was found in 26 patients (90%). Dilatation of peripheral artery was seen in 19 patients (65%). The predominant HRCT findings were centrilobular faint opacities in 26 patients (90%), centrilobular dense nodules in 15 (50%), and mosaic attenuation in 16 patients (54%). Mean extent of centrilobular faint opacities was 70% of lung field. Both interlobular septal thickening and thickening of bronchovascular bundles were seen in 10 patients (34%), respectively. In all three cases with pathological investigation, centrilobular faint opacities were diffusely distributed. In pathological specimens, plexiform lesions and dilated lesions were conspicuously found at centrilobular areas.
Conclusion: Centrilobular dense nodules and faint opacities on HRCT are common in the patients with PPH and pathologically correspond to centrilobular plexiform lesions, dilated lesions, and dilated arteries in more peripheral areas.
Questions about this event email: koz@radiol.med.osaka-u.ac.jp
Kozuka MD, T,
High-Resolution CT Findings of Primary Pulmonary Hypertension in 29 Patients: What Is Centrilobular Faint Opacities?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3105545.html
