Objective To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio (RVv/LVv) measured by chest CT with pulmonary arterial pressure estimated by echocardiography before lung transplantation.Methods We reviewed 104 cases of lung transplant.According to the mean pulmonary arterial pressure (mPAP) exceeding 25 mmHg by right heart catheterization,hypertensive group (n =74) and normotensive group (n =30) were set up.Risk factors were assessed individually and adjusted for confounding by a multivariable logistic regression analysis.The area under the curve (AUC) for predicting pulmonary hypertension on chest CT and echocardiography was calculated.Results RVv/LVv and echocardiography-derived ptlmonary arterial systolic pressure (PASP) were significantly different between the two groups (P ＜ 0.05).In the hypertensive group,there was strong correlation between the RVv/LVv and PASP from catheterization (R =0.82,P＜0.001),also between the P ASP from echocardiography and catheterization (R =0.60,P＜ 0.001).The ROC curve displayed that with 0.85 as the cutoff for RVv/LVv,the sensmitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 87.5％,91.8％ and 90.9％,respectively.The ROC curve also displayed that based upon an echocardiography-derived PASP of 35 mmHg as the cutoff point,the sensitivity,specificity and accuracy rate for predicting mPAP over 25 mmHg were 91.2％,90.8％ and 88.4％,respectively.Conclusion RV/LV volume ratios on chest CT and echocardiographic evaluation correlate well with PASP assessed by right heart catheterization and can be used to predict pulmonary hypertension with high sensitivity and specificity.