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. 2015 Apr;70(4):382-7.
doi: 10.1136/thoraxjnl-2014-206088. Epub 2014 Dec 18.

CT features of pulmonary arterial hypertension and its major subtypes: a systematic CT evaluation of 292 patients from the ASPIRE Registry

S Rajaram  1 , A J Swift  1 , R Condliffe  2 , C Johns  1 , C A Elliot  2 , C Hill  3 , C Davies  3 , J Hurdman  2 , I Sabroe  2 , J M Wild  1 , D G Kiely  2
Affiliations

CT features of pulmonary arterial hypertension and its major subtypes: a systematic CT evaluation of 292 patients from the ASPIRE Registry

S Rajaram et al. Thorax. 2015 Apr.

Abstract

We evaluated the prevalence and prognostic value of CT-pulmonary angiographic (CTPA) measures in 292 treatment naive patients with pulmonary arterial hypertension (PAH). Pulmonary artery calcification (13%) and thrombus (10%) were exclusively seen in PAH-congenital heart disease. Oesophageal dilation (46%) was most frequent in PAH-systemic sclerosis. Ground glass opacification (GGO) (41%), pericardial effusion (38%), lymphadenopathy (19%) and pleural effusion (11%) were common. On multivariate analysis, inferior vena caval area, the presence of pleural effusion and septal lines predicted outcome. In PAH, CTPA provides diagnostic and prognostic information. In addition, the presence of GGO on a CT performed for unexplained breathlessness should alert the physician to the possibility of PAH.

Keywords: Primary Pulmonary Hypertension.

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Figures

Figure 1
Figure 1
The pulmonary artery (PA) aorta ratio was obtained by measuring the widest transverse diameter of the PA (blue) and the corresponding transverse diameter of aorta (red).
Figure 2
Figure 2
Grading of tricuspid regurgitation. (A) 0=There is no reflux into IVC, (B) 2=reflux into IVC but not hepatic veins, (C) 3=reflux into IVC and proximal hepatic veins and (D) 4=reflux into IVC and distal hepatic veins.
Figure 3
Figure 3
(A) The maximum mid-transverse diameters of the RV (right arrow) and LV (left arrow) cavities were measured in the axial plane at their widest points between the inner surfaces of the free wall and the interventricular septum. (B) For assessing the right atrial margin (arrow) on CT, right atrial length was measured from the centre of tricuspid annulus to the superior right atrial margin. RV, right ventricle; LV, left ventricle.
Figure 4
Figure 4
Centrilobular ground glass pattern (A) and central ground glass pattern (B).
Figure 5
Figure 5
Flow chart demonstrating patient inclusion.
Figure 6
Figure 6
Kaplan–Myer curve demonstrating survival based on the presence/absence of pleural effusion.
See this image and copyright information in PMC

Comment in

References

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