Robert McCall BS, Presenter: Nothing to Disclose

James G. Ravenel MD, Abstract Co-Author: Nothing to Disclose

Aleksandra Granath, Abstract Co-Author: Nothing to Disclose

Paul J. Nietert PhD, Abstract Co-Author: Institutional research contract, General Electric Company

Richard Silver MD, Abstract Co-Author: Nothing to Disclose

To determine the validity of main pulmonary artery diameter (MPAD) as a marker of pulmonary hypertension in scleroderma patients with and without interstitial lung disease (ILD).

We cross-referenced the radiologic database with medical records to identify patients with both computed tomography (CT) scans and right-heart catheterization separated by no more than six months. Computed tomography scans were reviewed to determine MPAD and extent of ILD for each patient. ILD was scored by a single thoracic radiologist on a five-point scale for ground glass opacity and fibrosis. The same radiologist also determined the quality of delineation for the great vessels. For quality scans, the main pulmonary artery was subsequently measured by two separate observers to determine interobserver variability. Main pulmonary artery diameter was chosen based on an average of the two measurements. Mean pulmonary arterial pressures (mPAP) were determined by RHC. Patients were divided into either group A (n = 20) or group B (n = 27) based on the absence or presence of ILD respectively. Groups were compared using either the Student t test or Mann-Whitney U test depending on the distribution of each variable under consideration. The Spearman rank-correlation coefficient was calculated for each group to evaluate the correlation between MPAD and mPAP.

Interobserver agreement for the MPAD measurement was high with a Lin’s concordance correlation coefficient of 0.95. Groups A and B were similar with regard to MPAD (p = 0.28) and mPAP (p = 0.34) upon Mann-Whitney U testing. MPAD was strongly correlated with mPAP in both Group A (r = 0.67, p = 0.0012) and Group B (r = 0.78, p < 0.0001).

In our population with scleroderma, MPAD is strongly correlated with mPAP and may indicate the development of pulmonary hypertension independent of the presence of mild to moderate ILD.

Reporting of MPAD may be beneficial in the management of scleroderma by suggesting the existence of pulmonary arterial hypertension regardless of the presence of ILD.

McCall, R, Ravenel, J, Granath, A, Nietert, P, Silver, R, Relationship of Main Pulmonary Artery Diameter to Pulmonary Arterial Pressure in Scleroderma Patients with and without Interstitial Lung Disease.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007285.html