Distinguishing Chronic Thromboembolic Pulmonary Hypertension From Other Causes of Pulmonary Hypertension Using CT
Distinguishing Chronic Thromboembolic Pulmonary Hypertension From Other Causes of Pulmonary Hypertension Using CT
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DOI：
10.2214/ajr.17.17871
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发表时间：
2017-12-01
影响因子：
5
通讯作者：
Lang, Irene M.
中科院分区：
文献类型：
--
作者：
Grosse, Alexandra;Grosse, Claudia;Lang, Irene M.
客观的。本研究的目的是辨别影像学表现，将慢性血栓栓塞性肺动脉高压 (CTEPH) 与肺动脉高压 (PH) 的其他原因区分开来。材料和方法。共有 143 名确诊 PH 的患者（第 1 组，肺动脉高压；第 2 组，左心疾病引起的 PH；第 3 组，肺部疾病引起的 PH；第 4 组，CTEPH；第 5 组，由于不明或多因素机制引起的 PH）接受了 MDCT 血管造影。评估 CT 图像是否存在慢性肺栓塞 (PE)、节段血管大小差异、马赛克灌注、实质密度、支气管扩张和侧支动脉。 结果。 CTEPH 患者的慢性 PE 血管体征频率、节段血管大小差异、马赛克灌注、实质密度、支气管侧支动脉和支气管扩张在统计学上显着高于非血栓栓塞性 PH 患者。 CTEPH 患者的慢性 PE 血管体征、马赛克灌注、实质密度和无支气管壁增厚的支气管扩张明显高于第 1、2、3 和 5 组患者。CTEPH 患者与第 3 组和第 5 组患者之间的支气管侧支动脉频率没有显着差异。 结论。大多数 CTEPH 患者有慢性 PE 的直接血管体征。次要体征包括节段血管大小、马赛克灌注模式、实质密度、侧支支气管动脉和支气管扩张的差异，这有助于区分 CTEPH 与 PH 的其他原因。
OBJECTIVE. The purpose of this study was to discern imaging findings that separate chronic thromboembolic pulmonary hypertension (CTEPH) from other causes of pulmonary hypertension (PH).MATERIALS AND METHODS. A total of 143 patients with proven PH (group 1, pulmonary arterial hypertension; group 2, PH due to left heart disease; group 3, PH due to lung disease; group 4, CTEPH; and group 5, PH due to unclear or multifactorial mechanisms) underwent MDCT angiography. The CT images were assessed for the presence of chronic pulmonary embolism (PE), disparity in segmental vessel size, mosaic perfusion, parenchymal densities, bronchial dilatation, and collateral arteries.RESULTS. The frequencies of vascular signs of chronic PE, disparity in segmental vessel size, mosaic perfusion, parenchymal densities, bronchial collateral arteries, and bronchial dilatation were statistically significantly higher in patients with CTEPH than in patients with nonthromboembolic PH. Vascular signs of chronic PE, mosaic perfusion, parenchymal densities, and bronchial dilatation without bronchial wall thickening were significantly more frequent in patients with CTEPH than in patients in groups 1, 2, 3, and 5. There was no significant difference in the frequencies of bronchial collateral arteries between patients with CTEPH and patients in groups 3 and 5.CONCLUSION. Most patients with CTEPH have direct vascular signs of chronic PE. Secondary signs include disparity in segmental vessel size, mosaic perfusion pattern, parenchymal densities, collateral bronchial arteries, and bronchial dilatation, which help distinguish CTEPH from other causes of PH.