Imaging Analysis CT Pulmonary Artery Imaging For Idiopathic Pulmonary Artery Hypertension

Purpose:To evaluate the diagnostic value of CT pulmonary artery (CTPA) imaging with idiopathic pulmonary artery hypertension.Materials and Methods:16 patients with right heart catheterization (RHC) proven IPAH were retrospectively analysis. The imaging was analyzed including pulmonary parenchyma, pulmonary interstitial, mediastinal lymph nodes,pericardium and pleural cavity on the CTPA examination. Cardiovascular parameters were measured in CTPA including right ventricle biggest short axis diameter (RVD), left ventricle biggest short axis diameter (LVD), main pulmonary artery diameter (MPAD), right pulmonary artery diameter (RPAD), left pulmonary artery diameter (LPAD), right low pulmonary artery diameter (RLPAD), ascending aorta diameter (AAD) and descending aorta diameter (DAD), and parameters were calculated including the ratio of the main pulmonary and ascending aorta diameter (rPA)、the ratio of the ascending and descending aorta diameter (rAD)、 the ratio of the right ventricular and left ventricular short axis diameter (RV/LV). The relationship between sex, pulmonary, lymph nodes, pericardium, pleural and pulmonary arrery pressure (PAP) was analyzed by Spearman rank correlation analysis.All the parameters between mild-moderate (3 cases) and severe (13 cases) PAH were analyzed by independent sample T test. Different age groups (group C:<50 years;group D:≥50 years) of PAP was analyzed by Pearson rank correlation.Results:From January 2012 to April 2015, a total of 16 patients with RHC proven IPAH,Of 16 cases,all of right ventricle expanded,all of main,right and left pulmonary artery diameter dilated,7 cases patch exudative change,4 cases inhomogeneous perfusion showed "mosaic pattern",3 ill-definedcentrilobular nodules,5 cases mediastinal lymphadenopathy,9 cases pericardial effusion including 4 cases pleural effusion,3 cases bronchial artery dilated,1 cases secondary right pulmonary artery embolism. When comparing the presence or absence of pleural effusion,these was statistical difference of PAP (r=0.628, P=0.009). AAD and DAD were statistical difference between mild-moderate and severe PAH (t values were 2.250 and 3.293, P values were 0.041 and 0.005).PAP was statistical difference between difference age groups (r=-0.501,P=0.048).Conclusions:CTPA is very important examination for the diagnosis of IPAH. The changes of pulmonary,mediastinal, pericardial, pleural and the parameters of Cardiovascular can help IPAH diagnosis and evaluation.