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Use of small pulmonary vascular alterations to identify different types of pulmonary hypertension: a quantitative computed tomography analysis
Journal of X-Ray Science and Technology ( IF 3 ) Pub Date : 2021-11-28 , DOI: 10.3233/xst-211001
Chengxiao Xu 1 , Yue Zhang 2 , Ning Zhang 3 , Xiaoxuan Sun 3 , Qingwen Liu 2 , Qiang Wang 3 , Yinsu Zhu 1
Affiliation  

BACKGROUND:The morphological alterations of small pulmonary vessels measured by computed tomography (CT) is increasingly used in evaluation of suspected pulmonary hypertension (PH). OBJECTIVE: To investigate the significance alterations of quantitative assessment of small pulmonary vessels on chestCT in distinguishing different types of PH and their severity. METHODS: We retrospectively analyzed a dataset of 120 healthy controls (HCs) and 91 PH patients, including 34 patients with connective tissue diseases-related PH (CTD-PH), 26 patients with idiopathic pulmonary arterial hypertension (iPAH), and 31 patients with chronic obstructive pulmonary disease-related PH (COPD-PH). The CTD-PH patients were divided into mild to moderate PH (CTD-LM-PH) group (n = 17) and severe PH (CTD-S-PH) group (n = 17). A total of 53 CTD patients without PH (CTD-nPH) were enrolled for comparison with the CTD-PH. We measured the cross-sectional area of small pulmonary vessels < 5 mm2 (%CSA <5) and between 5–10 mm2 (%CSA5–10) as a percentage of total lung area among the populations included above and compared %CSA in different types of PH groups and HCs group. The mean pulmonary arterial pressure (mPAP) was measured by right heart catheterization. RESULTS: The %CSA5–10 of COPD-PH, CTD-PH, and iPAH patients increased (0.21±0.09, 0.49±0.20 and 0.61±0.20, p < 0.02) sequentially, while the %CSA <5 of CTD-PH, iPAH, and COPD-PH patients decreased (0.79±0.65, 0.65±0.38 and 0.52±0.27, p < 0.05) sequentially. The %CSA5–10 was significantly higher in CTD-S-PH patients than CTD-LM-PH patients and CTD-nPH patients (0.51±0.21, 0.31±0.15 and 0.28±0.12, p < 0.01). The %CSA5–10 was positively correlated with mPAP in the CTD-PH group. CONCLUSIONS: The quantitative parameters %CSA <5 and %CSA5–10 assessed by chest CT are useful for distinguishing different types of PH. In addition, the %CSA5–10 can provide information for identification of CTD-PH severity.

中文翻译:

使用小肺血管改变来识别不同类型的肺动脉高压:定量计算机断层扫描分析

背景:计算机断层扫描(CT)测量的肺小血管形态学改变越来越多地用于评估疑似肺动脉高压(PH)。目的:探讨胸部CT小肺血管定量评估在区分不同类型PH及其严重程度中的意义。方法:我们回顾性分析了 120 名健康对照(HCs)和 91 名 PH 患者的数据集,其中包括 34 名结缔组织病相关 PH(CTD-PH)患者、26 名特发性肺动脉高压(iPAH)患者和 31 名慢性阻塞性肺疾病相关 PH (COPD-PH)。CTD-PH患者分为轻中度PH(CTD-LM-PH)组(n=17)和重度PH(CTD-S-PH)组(n=17)。共招募了 53 名无 PH 的 CTD 患者(CTD-nPH)与 CTD-PH 进行比较。我们测量了上述人群中小于 5 mm2 (%CSA <5) 和介于 5-10 mm2 (%CSA5-10) 之间的小肺血管的横截面积占总肺面积的百分比,并比较了不同人群的 %CSA PH 基团和 HCs 基团的类型。通过右心导管术测量平均肺动脉压(mPAP)。结果:COPD-PH、CTD-PH和iPAH患者的%CSA5-10依次增加(0.21±0.09、0.49±0.20和0.61±0.20,p<0.02),而CTD-PH的%CSA<5, iPAH 和 COPD-PH 患者依次下降(0.79±0.65、0.65±0.38 和 0.52±0.27,p < 0.05)。CTD-S-PH 患者的 %CSA5-10 显着高于 CTD-LM-PH 患者和 CTD-nPH 患者(0.51±0.21、0.31±0.15 和 0.28±0.12,p < 0. 01)。CTD-PH 组中 %CSA5-10 与 mPAP 呈正相关。结论:胸部 CT 评估的定量参数 %CSA <5 和 %CSA5-10 有助于区分不同类型的 PH。此外,%CSA5-10 可以提供用于识别 CTD-PH 严重程度的信息。
更新日期:2021-12-01
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