Introduction Pulmonary hypertension (PH) has significant
morbidity and mortality. Chest computed tomography (CT)
scans are increasingly used in the evaluation of patients with
dyspnea, including those with suspected PH.
Aim The aim was to study the signs of PH shown by CT
scans, and to correlate the data obtained with
echocardiography in suspected patients with PH in a trial to
select patients who are eligible for right-heart catheterization
and to confirm the diagnosis of PH in those patients who
cannot tolerate right-heart catheterization.
Patients and methods This study included 60 patients (50
patients with pulmonary hypertension and 10 patients with no
PH) aged 32–70 years. They underwent high-resolution CT
(23 cases) and computed tomography pulmonary
angiography (37 cases) using 16 multidetector computed
tomography scanner for the evaluation of their pulmonary
parenchyma and mediastinal structures to detect different
diagnostic criteria, causes, associations, and complications
of PH. All the 60 patients underwent echocardiography.
Results The main pulmonary artery (MPA) was larger than
29mm in 94% of the echo-positive cases and in 30% of the
echocardiography-negative cases. A more than 1 : 1
relationship between the segmental pulmonary artery and the
bronchus in at least three pulmonary lobes was seen in 84%
of positive cases and in none of the negative cases. A more
than 1 : 1 relationship between the MPA and the aorta was
seen in 80% of positive cases and in 20% of negative cases.
Correlation between MPA diameter in CT and the pulmonary
artery systolic pressure measured by echocardiography in all
cases showed significant correlation, with a P value of up to
0.001.
Conclusion Although right-heart catheterization is the gold
standard for the measurement of pulmonary artery pressure,
this procedure is not without risk and expense. Multidetector
computed tomography (computed tomography pulmonary
angiography or high resolution CT (HRCT) can reliably be
used, in addition to echocardiography, for the routine
evaluation of patients with PH.
Egypt J Bronchol 2016 10:310–318
© 2016 Egyptian Journal of Bronchology |
