The predictive value of CT pulmonary angiography combined with echocardiography for the degree of pulmonary hypertension

Ningli Dong; Honggang Yang; Huanhuan Hei; Youmin Guo; Xiaoyi Duan; Cong Shen

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The predictive value of CT pulmonary angiography combined with echocardiography for the degree of pulmonary hypertension

VernacularTitle:CT肺动脉造影的多参数测量联合心动超声对肺动脉高压程度的预测价值
Author: Ningli DONG ^{1
,

2} ; Honggang YANG ³ ; Huanhuan HEI ⁴ ; Youmin GUO ¹ ; Xiaoyi DUAN ¹ ; Cong SHEN ¹
Author Information

1. Department of PET/CT, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
2. Department of Medical Imaging, Baoji No.2 Hospital of Traditional Chinese Medicine, Baoji 721300
3. Department of Medical Imaging, Baoji No.2 Hospital of Traditional Chinese Medicine, Baoji 721300
4. Department of Imaging, The Second Affiliated Hospital of Xi’an Medical College, Xi’an 710038, China
Publication Type:Journal Article
Keywords: pulmonary hypertension; right cardiac catheterization; CTPA; echocardiography; predictive model
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(2):275-282
CountryChina
Language:Chinese
Abstract: 【Objective】 To compare the value of CT pulmonary angiography (CTPA) and echocardiography in predicting the degree pulmonary hypertension (PH). 【Methods】 Fifty-four patients in our hospital who underwent right heart catheterization, CTPA and echocardiography for suspected or confirmed PH from November 2013 to April 2021 were retrospectively recruited. Pulmonary artery systolic pressure (PASP) and mean pulmonary artery pressure (PAMP) were measured by right heart catheterization. According to PAMP, the patients were divided into non-PH group and mild, moderate, and severe PH groups. The three-dimensional model of the pulmonary artery was obtained by computer-aided segmentation, and the best fitting circle diameter (Dfit), inscribed circle diameter (Dmin), circumscribed circle diameter (Dmax), hydraulic diameter (Dh), cross-sectional area (Area), circumference (Scf), and the largest area and largest short diameter of the right ventricle were measured. Echocardiography was used to estimate PASP. The differences in the above parameters between different PH groups were compared, the correlations of the above parameters with PASP and PAMP were analyzed, and statistically significant indicators were included to establish three predictive models of PAMP (Model 1: CTPA pulmonary artery; Model 2: CTPA pulmonary artery+CTPA right ventricle; Model 3: CTPA pulmonary artery+CTPA right ventricle+echocardiography), and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of the three models. 【Results】 Some parameters of main pulmonary artery (Dfit, Dmin, Dmax, Dh, Area, Scf), right pulmonary artery (Dmax, Dh, Area, Scf), left pulmonary artery (Dfit), and right ventricular short diameter increased with the increase of PAMP (P<0.05). Dfit, Dmin, Dh, and area of main pulmonary artery, right pulmonary artery and left pulmonary artery were positively correlated with PASP and PAMP (P<0.05). Right ventricular short diameter and right ventricular maximum area were positively correlated with PASP (P<0.05), and right ventricular short diameter was positively correlated with PAMP (P<0.05). The estimated value of pulmonary artery systolic blood pressure in echocardiography was positively correlated with PASP and PAMP (P<0.05). Model 1, Model 2 and Model 3 could all be used to identify mild PH and moderate PH, among which Model 3 had the best performance in identifying non-PH and mild PH, moderate PH and severe PH. 【Conclusion】 CTPA and echocardiography are helpful in assessing the degree of PH, and the combination of the two has better accuracy in distinguishing non-PH from mild PH, moderate and severe PH.