The Clinical Application Of CT Pulmonary Angiography In The Severity Of Pulmonary Hypertension

Objective: To investigate the correlation between the parameters of pulmonary arteries measured on computed tomography pulmonary angiography(CTPA)and pulmonary hypertension(PH),and to screen out the parameters highly correlated with PH,and to study the value of the highly relative parameters for the severity of PH assessment.Methods: The study was approved by the ethics committee of North Sichuan Medical college.100 PH patients of the observation group and 30 cases of the control group were enrolled from January 2013 to September2016.The PH patients were divided into mild group(n=45),moderate group(n=43),severe group(n=13),according to the Doppler echocardiographic criteria.Allergy to iodine and intolerant examiners were excluded.Parameters of the pulmonary arteries were measured and calculated on CTPA,including the inner diameters of the main pulmonary artery(MPAD),the ascending aorta on the same slice(AD),the right pulmonary artery(RPAD),the right lower lobe pulmonary artery(RLPAD),the posterior basal segmental artery of right lower lobe,and the left pulmonary artery(LPAD),the posterior basal segmental artery of left lower lobe,the ratio of the main pulmonary artery to the ascending aorta on the same slice(PA/A).group T-test,one-way ANOVA,LSD method,Spearman rank correlation,ROC curve analysis were used for data analysis.Results:(1)Comparison of the pulmonary artery parameters between the observation group and the control group showed significant differences.(p<0.05);(2)So did the parameters among the mild,moderate,and severe PH group(p<0.05);(3)The pariwise comparison of the pulmonary artery parameters between the mild,moderate,and severe PH group showed significant differences in the MPAD,the PA/A,the RLPAD,and the posterior basal segmental artery of right lower lobe(p<0.05),which were highly correlated with PH,correlation coefficient were 0.454,0.669,0.433,0.496,respectively(p<0.05);(4)the optimal threshold of MPAD,PA/A,RLPAD,and the posterior basal segmental artery of right lower lobe in mild,moderate,and severe PH(p<0.05): the MPAD were 26.04 mm,29.78 mm,and 32.54 mm,respectively,area under curve(AUC)of ROC were 0.920,0.727,0.756,respectively;PA/A were 0.76,0.94,and 1.05,respectively,AUC were 0.677,0.851,0.745,respectively;RLPAD were 14.71 mm,17.33 mm,and 17.53 mm,respectively,AUC were 0.719,0.684,0.687,respectively;the posterior basal segmental artery of right lower lobe were 2.40 mm,3.37 mm,and 4.38 mm,respectively,AUC were 0.660,0.668,0.777,respectively.Conclusions: PH can be predicted and assessed with CTPA;the change of the inner diameter of the posterior basal segmental artery of right lower lobe can be used as a new reference,and to assist other indicators in the diagnosis and severity assessment of PH.