Introduction: Pulmonary hypertension (PH) has significant morbidity and mortality. Computerized tomography (CT) chest scans are increasingly utilized in the evaluation of patients with dyspnea, including those with suspected PH.
The aim of this study: was to study the signs of pulmonary hypertension shown by CT scans, and correlate the data obtained with echocardiography in suspected patients with pulmonary hypertension in a trial to select patients eligible for right heart catheterization & to confirm diagnosis of (PH) in those patients who can’t tolerate RT heart catheterization.
Patients and methods: This study included 60 patients (50 patients with Pulmonary Hypertension and 10 patients with no pulmonary hypertension), aged (32-70). They underwent high- resolution CT (23 cases) and CT pulmonary angiography (37 cases) using 16 MDCT (multidetector CT) scanner for evaluation of their pulmonary parenchyma, and mediastinal structures to detect different diagnostic criteria, causes, associations, and complications of pulmonary hypertension. All the 60 patients underwent echocardiography.
Results: The main pulmonary artery (MPA) was larger than 29 mm in 94% of the echo positive cases and 30% of the echo 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 non of negative cases. A more than 1: 1 relationship between the MPA and the aorta was seen in 80% of positive cases and 20% of negative cases. Correlation between MPA diameter in CT and the pulmonary artery systolic pressure measured by echo 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. MDCT (CTPA or HRCT) can reliably be used, in addition to echocardiography, for the routine evaluation of patients with PH.
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