Neal Corson1, Samuel G Armato2, Zacariah E Labby1, Christopher Straus1, Adam Starkey1, Mardi Gomberg-Maitland3. 1. Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637. 2. Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637. Electronic address: s-armato@uchicago.edu. 3. Department of Medicine, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
Abstract
RATIONALE AND OBJECTIVES: Pulmonary hypertension (PH) is a complex and fatal disease that is difficult to diagnose noninvasively. This study evaluated previously published computed tomography-based vessel measurement criteria and investigated the predictive power and diagnostic ability of the main pulmonary artery diameter (MPAD) and the ratio of MPAD to aorta diameter (rPA). MATERIALS AND METHODS: The database for this study consisted of 175 PH patients (for whom mean pulmonary artery pressure [mPAP] was known), 16 patients without PH but with known mPAP (non-PH patients), and 114 "normal" patients without known mPAP. The performance of previously published criteria, MPAD > 29 mm and rPA > 1, was determined. The relationship between vessel measurements and mPAP was evaluated through correlation and linear regression analysis. The ability of these measurements to discriminate between patients with and without PH was determined by receiver operating characteristic analysis. RESULTS: For discriminating between PH and "normal" patients, the sensitivity and specificity of the criterion MPAD > 29 mm were 0.89 (0.84-0.93) and 0.83 (0.76-0.90), respectively, and the sensitivity and specificity of the criterion rPA > 1 were 0.89 (0.85-0.94) and 0.82 (0.74-0.89), respectively. At a specificity of 0.95 in the task of separating PH and "normal" patients, the sensitivity of MPAD was 0.81 (0.72-0.90) and the sensitivity of rPA was 0.76 (0.66-0.85), but the specificity for both decreased when non-PH patients were included. For the combined PH and non-PH patient groups, the correlation between the vessel measurements and mPAP was significant but low, and the ability of the vessel measurements to predict mPAP was limited. CONCLUSION: This study found that the sensitivity of previously published vessel criteria for identifying PH patients is high, but the specificity may not be high enough for routine use in a clinical patient population.
RATIONALE AND OBJECTIVES:Pulmonary hypertension (PH) is a complex and fatal disease that is difficult to diagnose noninvasively. This study evaluated previously published computed tomography-based vessel measurement criteria and investigated the predictive power and diagnostic ability of the main pulmonary artery diameter (MPAD) and the ratio of MPAD to aorta diameter (rPA). MATERIALS AND METHODS: The database for this study consisted of 175 PH patients (for whom mean pulmonary artery pressure [mPAP] was known), 16 patients without PH but with known mPAP (non-PH patients), and 114 "normal" patients without known mPAP. The performance of previously published criteria, MPAD > 29 mm and rPA > 1, was determined. The relationship between vessel measurements and mPAP was evaluated through correlation and linear regression analysis. The ability of these measurements to discriminate between patients with and without PH was determined by receiver operating characteristic analysis. RESULTS: For discriminating between PH and "normal" patients, the sensitivity and specificity of the criterion MPAD > 29 mm were 0.89 (0.84-0.93) and 0.83 (0.76-0.90), respectively, and the sensitivity and specificity of the criterion rPA > 1 were 0.89 (0.85-0.94) and 0.82 (0.74-0.89), respectively. At a specificity of 0.95 in the task of separating PH and "normal" patients, the sensitivity of MPAD was 0.81 (0.72-0.90) and the sensitivity of rPA was 0.76 (0.66-0.85), but the specificity for both decreased when non-PH patients were included. For the combined PH and non-PH patient groups, the correlation between the vessel measurements and mPAP was significant but low, and the ability of the vessel measurements to predict mPAP was limited. CONCLUSION: This study found that the sensitivity of previously published vessel criteria for identifying PH patients is high, but the specificity may not be high enough for routine use in a clinical patient population.
Authors: Gérald Simonneau; Ivan M Robbins; Maurice Beghetti; Richard N Channick; Marion Delcroix; Christopher P Denton; C Gregory Elliott; Sean P Gaine; Mark T Gladwin; Zhi-Cheng Jing; Michael J Krowka; David Langleben; Norifumi Nakanishi; Rogério Souza Journal: J Am Coll Cardiol Date: 2009-06-30 Impact factor: 24.094
Authors: Shirin Sanal; Wilbert S Aronow; Gautham Ravipati; George P Maguire; Robert N Belkin; Stuart G Lehrman Journal: Cardiol Rev Date: 2006 Sep-Oct Impact factor: 2.644
Authors: Vivien M Hsu; Abel E Moreyra; Alan C Wilson; Meir Shinnar; Daniel M Shindler; Julianne E Wilson; Ami Desai; James R Seibold Journal: J Rheumatol Date: 2008-01-15 Impact factor: 4.666
Authors: Onno A Spruijt; Harm-Jan Bogaard; Martijn W Heijmans; Rutger J Lely; Mariëlle C van de Veerdonk; Frances S de Man; Nico Westerhof; Anton Vonk-Noordegraaf Journal: Int J Cardiovasc Imaging Date: 2015-02-17 Impact factor: 2.357