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Multidetector Computed Tomography for Detection and Characterization of Pulmonary Hypertension in Consideration of WHO Classification

Dornia, Christian MD; Lange, Tobias J.; Behrens, Gundula; Stiefel, Jaroslava; Müller-Wille, René; Poschenrieder, Florian; Pfeifer, Michael; Leitzmann, Michael; Manos, Daria; Babar, Judith L.; Stroszczynski, Christian; Hamer, Okka W.

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e31824afbdf
Thoracic Imaging
Abstract

Objective: We evaluated the reliability of various multidetector computed tomography (MDCT) parameters for diagnosis and severity assessment of pulmonary hypertension (PH) with consideration of World Health Organization (WHO) classification.

Methods: A total of 172 patients were included in this retrospective study. One hundred fourteen patients had a diagnosis of PH (mean pulmonary artery pressure ≥25 mm Hg), and 58 patients without PH (mean pulmonary artery pressure <20 mm Hg) served as control subjects. The patients with PH were grouped according to the WHO classification based on PH etiology.

Results: The patients with PH had significantly greater main, left, and right pulmonary artery diameters than the control subjects (P < 0.001). No significant differences within the PH subgroups were found. Receiver operating characteristic analysis showed reasonable sensitivity and specificity for selected MDCT parameters. The severity of PH did not correlate with MDCT parameters.

Conclusions: Easy-to-determine MDCT parameters allow detection of PH independent of the WHO group. In patients with dilated aorta, the vertebra can be an alternative internal standard. Severity of PH cannot be estimated by MDCT parameters.

Author Information

From the Departments of *Radiology, †Internal Medicine II, and ‡Epidemiology and Preventive Medicine, University Medical Center Regensburg, Germany; §Center for Pneumology, Donaustauf Hospital, Germany; ∥Department of Radiology, Dalhousie University, Halifax, Canada; and ¶Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK.

Received for publication September 11, 2011; accepted January 12, 2012.

Reprints: Christian Dornia, MD, Department of Radiology, University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany (e-mail: christian.dornia@klinik.uni-regensburg.de).

The authors report no conflicts of interest.

All authors approved the final version of the manuscript for publication. CD is the main author of the manuscript. TJL, JS, and OWH contributed to the study design and data acquisition and analysis. GB and ML performed the statistical analyses. DM, JLB, RMW, FP, MP, CS, and OWH critically revised and edited the manuscript.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.