Pulmonary arterial hypertension is a devastating disease with significant disability and mortality, and it has much higher prevalence than previously thought.
The aim was to study the signs of pulmonary hypertension shown by computed tomography (CT) scans and correlate the data obtained with echocardiography in suspected patients with pulmonary hypertension in a trial to survey patients eligible for right heart catheterization.
Patients and methods
In this study, 50 patients underwent high-resolution CT (18 cases) or CT pulmonary angiography (32 cases) using a 4-MDCT scanner for evaluation of their pulmonary parenchyma, pulmonary vasculature, and mediastinal structures to detect different diagnostic criteria, types, causes, associations, and complications of pulmonary arterial hypertension. All the 50 patients underwent echocardiography.
In all cases, the main pulmonary artery (MPA) was larger than 29 mm, and was further divided according to the size into three groups (<35 mm = 52%, >35<40 mm = 22%, and ≥40 mm = 26%). A more than 1 : 1 relationship between the segmental pulmonary artery and the bronchus in different pulmonary lobes was seen in 78% of the cases. A more than 1 : 1 relationship between the MPA and the aorta was seen in 76% of the cases. Correlation between MPA and the mean pulmonary artery pressure measured in 50 cases showed significant correlation, with a P value of up to 0.001. According to other CT findings, the causes were divided into four groups.
Although right heart catheterization is the gold standard for the measurement of pulmonary artery pressure, this procedure is not without risk and expense. There is a need for accurate noninvasive markers that can be used appropriately to stratify patients for referral for right-sided heart catheterization. Egypt J Broncho 2013 7:60–66