Toshihiko Sugiura, Presenter: Nothing to Disclose

Nobuhiro Tanabe, Abstract Co-Author: Nothing to Disclose

Yukiko Matsuura, Abstract Co-Author: Nothing to Disclose

Naoko Kawata MD, Abstract Co-Author: Nothing to Disclose

Hajime Kasai, Abstract Co-Author: Nothing to Disclose

Koichiro Tatsumi, Abstract Co-Author: Nothing to Disclose

We retrospectively determined whether changes of the curvature of the interventricular septum measured by ECG-gated 320-slice CT were influenced by improved pulmonary artery (PA) pressure in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary endarterectomy (PEA).

Thirty-six patients (13 male, 59±9 yrs) with proven CTEPH underwent right heart catheterization (RHC) and double-volume retrospective ECG-gated enhanced volume scanning using 320-slice CT before and after PEA. CT images were reconstructed every 5% from 0-95% of the R-R interval, and a series of short-axis images of the heart at the level of the left ventricle papillary muscle was acquired using double-oblique multiplanar reformation. Septal bowing expressed as end-systolic curvature (reciprocal of radius [/cm]) was measured (a leftward curvature was denoted as a negative value). The relationships between septal curvature and hemodynamics measured by RHC before and after PEA were evaluated by linear regression analysis.

The correlation coefficients of septal curvature with systolic PA pressure (sPAP) before and after PEA were -0.83 (P<0.001) and -0.46 (P=0.005), respectively. The correlation coefficients of septal curvature with mean PA pressure (mPAP) before and after PEA were -0.83 (P<0.001) and -0.46 (P=0.005), respectively. The change in septal curvature before and after PEA was also correlated with the change in sPAP (r=-0.64, P<0.001) and the change in mPAP (r=-0.65, P<0.001).

Septal curvature based on ECG-gated 320-slice CT can be used to accurately estimate improved hemodynamics in patients undergoing PEA.This imaging modality can be used to detect thrombi in the pulmonary arteries as well as to evaluate hemodynamics in CTEPH subjects.

Septal bowing expressed as end-systolic curvature based on ECG-gated 320-slice CT can be used to accurately estimate improved hemodynamics in patients undergoing PEA.

Sugiura, T, Tanabe, N, Matsuura, Y, Kawata, N, Kasai, H, Tatsumi, K, Relationship between Improved Pulmonary Arterial Pressure and Changes in Interventricular Septal Configuration by 320-Slice CT in Patients under Pulmonary Endarterectomy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013812.html