The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension
The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension
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DOI：
10.1148/radiol.2492080269
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发表时间：
2008-12-01
期刊：
影响因子：
19.7
通讯作者：
Hansell, David M.
中科院分区：
文献类型：
--
作者：
Devaraj, Anand;Wells, Athol U.;Hansell, David M.
目的：目的：探讨肺动脉（PA）扩张是否是肺纤维化患者肺动脉高压（PH）的可靠指标。不需要患者同意。研究了77例接受右心导管插入术的患者（39例男性，38例女性）。研究人群分为30例肺纤维化患者（A组）和47例无肺纤维化患者（B组）。应用CT测量A组主动脉直径（dPA）和升主动脉直径（dAA），并记录纤维化程度。dPA和dPA/dAA比值与平均PA压（mPAP）和肺血管阻力指数（PVRi）相关（斯皮尔曼等级）。结果：B组dPA与mPAP（r = 0.67，P <0.0001）和PVRi（r = 0.78，P <0.0001）均呈显著相关。相比之下，A组中无显著相关性（mPAP r = 0.23，P <0.22，PVRi r = 0.23，P = 0.28）。在B组中，dPA/dAA比值与单独使用dPA的相关性相似（mPAP的r = 0.72，P < .0001; PVRi的r = 0.71，P < .0001），但在A组中，相关性显著增强（mPAP的r = 0.54，P < .005; PVRi的r = 0.48，P < .04）。PA扩张发生在A组中没有显着的PH，并不相关的CT纤维化评分或TLC.Conclusion：PA扩张发生在没有PH的肺纤维化患者，因此是一个不可靠的迹象，在这些患者的PH。(c)RSNA，2008年
Purpose: To determine whether pulmonary artery (PA) dilatation is a reliable indicator of pulmonary hypertension (PH) in patients with pulmonary fibrosis.Materials and Methods: This study had institutional review board approval. Patient consent was not required. Seventy-seven patients (39 men, 38 women) who underwent right heart catheterization were studied. The study population was divided into 30 patients with pulmonary fibrosis (group A), and 47 without (group B). The main PA diameter (dPA) and ascending aorta diameter (dAA) were measured by using computed tomography (CT), and the extent of fibrosis was recorded in group A. The dPA and the dPA/dAA ratio were correlated (Spearman rank) with mean PA pressure (mPAP) and pulmonary vascular resistance index (PVRi). The relationship between dPA and pulmonary fibrosis extent and total lung capacity (TLC) was examined by using multivariate linear regression.Results: There were strong correlations between dPA and both mPAP (r = 0.67, P < .0001) and PVRi (r = 0.78, P < .0001) in group B. In contrast, there were no significant correlations in group A (r = 0.23, P < .22 for mPAP and r = 0.23, P = .28 for PVRi). The dPA/dAA ratio had similar relationships to dPA alone in group B (r = 0.72, P < .0001 for mPAP and r = 0.71, P < .0001 for PVRi), but significantly strengthened the correlations in group A (r = 0.54, P < .005 for mPAP and r = 0.48, P < .04 for PVRi). PA dilatation occurred in group A in the absence of significant PH, and was unrelated to CT fibrosis score or TLC.Conclusion: PA dilatation occurs in the absence of PH in patients with pulmonary fibrosis and is therefore an unreliable sign of PH in these patients. (c) RSNA, 2008