The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension

Devaraj, Anand; Wells, Adrian; Meister, Mark G.; Corte, Tamera J.; Hansell, David M.

doi:10.1148/radiol.2492080269

Cited by 141 publications

(114 citation statements)

References 31 publications

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“…Also, pulmonary artery dilatation can occur in the absence of PHT in patients with pulmonary fibrosis and is therefore an unreliable sign of PHT in this cohort [51]. Devaraj et al [52] showed that a composite index of the ratio of the diameter of the MPA and ascending aorta combined with echocardiography-derived right ventri- Right heart on multidetector CT…”

Section: Pulmonary Hypertensionmentioning

confidence: 82%

Right heart on multidetector CT

Gopalan

2011

BJR

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ABSTRACT. Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart.

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Section: Pulmonary Hypertensionmentioning

confidence: 82%

Right heart on multidetector CT

Gopalan

2011

BJR

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“…Such a phenomenon has been described in the portal vein with advancing degrees of cirrhosis-induced portal hypertension, whereby a portal vein may not be free to fully dilate in response to elevated pressures in chronic settings because of a constricting stiff liver or vessel wall. 31 The pulmonary vasculature may be free to dilate without the constraints of an inelastic environment or restricted motion.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Correlates with Cardiopulmonary Hemodynamics in Pulmonary Hypertension in Adults with Sickle Cell Disease

et al. 2014

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Our objective was to determine whether computed tomography angiography (CTA) measurements of pulmonary artery size can noninvasively assess hemodynamics and diagnose pulmonary hypertension (PH) secondary to sickle cell disease (SCD). Twenty SCD patients with confirmed PH were compared with 20 matched controls. Diameters of the pulmonary artery trunk and branches were measured with CTA and a semiautomatic segmentation algorithm. Measurements were normalized by body size and correlated (Spearman rank) with hemodynamic markers from right-heart catheterization. Receiver operating characteristic (ROC) curves were used to investigate the role of pulmonary artery sizes in diagnosing PH. Analysis of pulmonary artery sizes adjusted for body surface area (BSA) resulted in the most significant discrimination between subjects with PH secondary to SCD and controls (P < 0.001); PH was diagnosed accurately with an area under the ROC curve of 0.99. There was significant correlation between pulmonary artery sizes and body mass index (BMI) and BSA only in controls (r ¼ 0.46-0.68, P < 0.04 for all). The most significant correlations with hemodynamic markers were found between BMIadjusted pulmonary artery sizes and high systolic pulmonary arterial pressure, high pulmonary vascular resistance, high systemic vascular resistance, and low cardiac output (r ¼ 0.47, 0.62, 0.61, and 0.66, respectively; P < 0.04 for all). BMI-adjusted CTA measures of the pulmonary artery relate to high pulmonary vascular resistance and reduced cardiac output in patients with SCD and PH. CTA with quantitative image analysis is a powerful noninvasive diagnostic tool for PH in SCD and shows promise as estimator of hemodynamic markers.

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“…3 In patients with interstitial lung disease, the pulmonary artery may be dilated without the corresponding increase in pressure. 4 Dilated pulmonary arteries can cause extrinsic compression on the left main stem coronary artery (Figure 1). The left main stem is typically effaced and displaced caudally.…”

Section: Vascular Complicationsmentioning

confidence: 99%

Complications of pulmonary hypertension: a pictorial review

Mak¹,

Strickland²,

Gopalan³

2017

The British Journal of Radiology

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Pulmonary hypertension (PH) is a rare disease with a significant morbidity and mortality if untreated. The disease has a multifactorial aetiology and is often associated with insidious onset of signs and symptoms. Multimodality imaging is often required for establishing the diagnosis, evaluating the underlying haemodynamic compromise and follow-up after institution of therapy. The range of potential complications associated with PH vary widely. We aimed to summarize the imaging findings of complications that the radiologist should be familiar with.

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The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension

Abstract: PA dilatation occurs in the absence of PH in patients with pulmonary fibrosis and is therefore an unreliable sign of PH in these patients.

Cited by 141 publications

References 31 publications

Right heart on multidetector CT

Right heart on multidetector CT

Computed Tomography Correlates with Cardiopulmonary Hemodynamics in Pulmonary Hypertension in Adults with Sickle Cell Disease

Complications of pulmonary hypertension: a pictorial review

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