Marie-Pierre Revel Dubois, Presenter: Nothing to Disclose

Martine J. Remy-Jardin MD, PhD, Abstract Co-Author: Nothing to Disclose

Jean-Baptiste Faivre MD, Abstract Co-Author: Nothing to Disclose

Nathalie Courtois, Abstract Co-Author: Nothing to Disclose

Laura Menchini, Abstract Co-Author: Nothing to Disclose

Jacques Remy MD, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy of functional parameters in the depiction of pulmonary hypertension (PHT).

The ECG-gated CT scans of 25 patients who had undergone right heart catheterization within 1 month of CT in the clinical context of chronic bronchopulmonary (n=17) or pulmonary vascular (n=8) diseases were retrospectively reviewed to analyze morphological and dynamic changes at the level of the right ventricular outflow tract (ROVT) and right pulmonary artery (RPA) on systolic and diastolic 2D reformations. The study group included 18 males and 7 females (mean age: 59.72 years) who had undergone an ECG-gated 64-slice multidetector-row CT examination of the entire thorax as part of their clinical work-up owing to the possibility to provide information on the underlying respiratory disease and right cardiac function (CT protocol approved by the local Ethics Committee). Hemodynamic features of PHT were present in 11 patients (mean pulmonary artery pressure: 38.45 mmHg; range: 26-56) and absent in 14 patients (mean pulmonary artery pressure: 17.1 mmHg; range: 11-23). Systolic and diastolic measurements were performed independently by two experienced radiologists.

Four parameters showed significant differences in the presence of PHT: the diameter of the pulmonary trunk (p=0.005), the diastolic (p=0.03) and systolic (p=0.006) thickness of the myocardium at the level of the RVOT and the distensibility of the RPA (0.008). For each of these variables, it was possible to define a threshold predictive of PHT (pulmonary trunk: 31.65 mm - specificity: 100%; diastolic thickness of the RVOT : 5.67 mm - specifity : 100% ; systolic thickness of the RVOT: 8.02 mm - specificity : 100%; distensibility of the RPA : 16% - specificity : 100%). The parameter showing the highest correlation with values of the pulmonary artery pressure was the distensibility of the RPA (r = - 0.74; p<0.05), also observed with the highest interobserver agreement using the Fleiss’ method (r=0.93).

Functional CTA could allow a noninvasive approach of PHT.

ECG-gated 64-slice multidetector-row CT can provide functional information in patients with pulmonary hypertension.

Revel Dubois, M, Remy-Jardin, M, Faivre, J, Courtois, N, Menchini, L, Remy, J, ECG-gated 64-slice Multi-detector Row CT Angiography of the Chest: Can Functional Parameters Help Predict Pulmonary Hypertension ?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4438291.html