Computed Tomography Angiography-Based Pulmonary Artery Volumetry as a Diagnostic Tool for Pulmonary Hypertension

J Comput Assist Tomogr. 2020 Sep/Oct;44(5):681-686. doi: 10.1097/RCT.0000000000001082.

Abstract

Objectives: We evaluated use of three-dimensional pulmonary artery volumes derived from computed tomography pulmonary angiography (CTPA) in a group with pulmonary hypertension (PH) compared with healthy controls as a tool for the diagnosis of PH.

Methods: Retrospective analysis was performed of 40 CTPA scans obtained within 90 days of right heart catheterization demonstrating PH. The CTPA scans of 40 age- and sex-matched patients without cardiopulmonary disease were used as comparison. Diameters and volumes of the pulmonary arteries were compared.

Results: Adjusted total volume of the main, right, and left proximal pulmonary arteries (PAvol) demonstrated area under the curve of 0.918 (95% confidence interval, 0.860-0.975) for detection of PH, comparable to main pulmonary artery diameter measurement. Area under the curve values for PAvol were higher in subgroups divided by sex and PH severity.

Conclusions: Volumetric analysis of the proximal pulmonary arteries using CTPA is a promising diagnostic tool for PH in a real-world cohort.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Computed Tomography Angiography / methods*
  • Female
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / pathology
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / pathology
  • Retrospective Studies
  • Sensitivity and Specificity