scholarly journals Performance of pulmonary artery dimensions measured on high-resolution computed tomography scan for identifying pulmonary hypertension

2020 ◽  
Vol 6 (1) ◽  
pp. 00232-2019
Author(s):  
Pailin Ratanawatkul ◽  
Andrea Oh ◽  
J. Caleb Richards ◽  
Jeffrey J. Swigris
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Predictive Value ◽  
High Specificity ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Entire Cohort ◽  
Right Heart Catheterisation

BackgroundOn high-resolution computed tomography (HRCT), pulmonary artery (PA) dimensions may hint at the presence of pulmonary hypertension. We aimed to determine how accurately various measures of the PA, as viewed on HRCT, predict right heart catheterisation (RHC)-confirmed pulmonary hypertension.MethodsWe retrospectively reviewed patients who had HRCT and RHC between 2010 and 2018. Analyses considered respiratory cycle, pulmonary hypertension diagnostic criteria, time between HRCT and RHC, and subgroup analysis in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD).ResultsOf 620 patients, 375 had pulmonary hypertension. For pulmonary hypertension (defined as mean PA pressure (mPAP) ≥25 mmHg) and from HRCT performed within 60 days of RHC, main PA diameter (MPAD) ≥29 mm had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 42%, 0.70 and 0.70, respectively, while ratio of the diameter of the PA to the diameter of the ascending aorta (PA:Ao) ≥1.0 showed 53%, 85%, 0.84 and 0.54, respectively. In general, results were similar when the interval between HRCT and RHC varied from 7 to 60 days and when measured on expiratory images. In ILD, the sensitivity of MPAD was higher; in COPD, the specificity of PA:Ao was higher. There was moderately positive correlation between mPAP and inspiratory MPAD, PA:Ao, right PA diameter (RPAD), left PA diameter (LPAD) and (RPAD+LPAD)/2 (r=0.48, 0.51, 0.34, 0.34 and 0.36, respectively), whereas there was weak negative correlation between mPAP and PA angle (r= −0.24).ConclusionsFindings on HRCT may assist in the diagnosis of RHC-confirmed pulmonary hypertension. MPAD ≥29 mm had high sensitivity and PA:Ao ≥1.0 had high specificity. Compared with the entire cohort, MPAD had greater sensitivity in ILD and PA:Ao had higher specificity in COPD.

Predictors of Pulmonary Hypertension on High-resolution Computed Tomography of the Chest in Systemic Sclerosis: A Retrospective Analysis

2010 ◽  
Vol 61 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Anoop Kumar Pandey ◽  
Pearce Wilcox ◽  
John R. Mayo ◽  
Donald Sin ◽  
Robert Moss ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Maximum Diameter ◽  
Imaging Features ◽  
High Resolution Computed Tomography ◽  
Pulmonary Artery Diameter

Purpose To evaluate the imaging features on high-resolution computed tomography (HRCT) of the chest and the clinical parameters that are associated with pulmonary hypertension in systemic sclerosis. We specifically investigated whether main pulmonary artery (MPA) diameter and burden of lung fibrosis are predictors of pulmonary hypertension in these patients. Methods We retrospectively retrieved the database information of patients with systemic sclerosis seen at our hospital between January 2007 and December 2008. A total of 75 patients had HRCT of the chest, pulmonary function testing (PFT), and echocardiography within 6 months of each other. The echocardiography images were reviewed by a level-3 echocardiographer, and 29 cases were excluded because of suboptimal evaluation of pulmonary artery (PA) pressure. Peak PA pressures and PFT of the remaining 46 cases (43 women and 3 men) were charted. The PFT included total lung capacity (TLC), diffusion capacity of lung for carbon monooxide (DLCO) and the ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC). The HRCT of the chest of each patient was read by a chest radiologist. The extent of ground glass, reticulation, and honeycombing was objectively scored. The maximum diameter of the main pulmonary artery (MPAD) and ascending aorta were measured. The ratio of main pulmonary artery diameter and ascending aortic diameter (MPAD/AD) and ratio of main pulmonary artery diameter and body surface area (MPAD/BSA) were also calculated. Results Statistical analysis done by using a multivariate model showed that the calculated fibrotic score strongly correlated with peak PA pressures ( P < .001). MPAD ( P = .0175), and the ratio MPAD/AD ( P = .0102) also showed a statistically significant correlation with peak PA pressures. By using stepwise regression analysis, the fibrotic score was found to be the most reliable independent predictor of pulmonary hypertension. Conclusion HRCT-determined severity and extent of pulmonary fibrosis may be helpful in screening for pulmonary hypertension in patients with systemic sclerosis.

Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

scholarly journals Phenotyping of Chronic Obstructive Pulmonary Disease Using the Modified Bhalla Scoring System for High-Resolution Computed Tomography

2013 ◽  
Vol 20 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Baykal Tulek ◽  
Ali Sami Kivrak ◽  
Seda Ozbek ◽  
Fikret Kanat ◽  
Mecit Suerdem
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Scoring System ◽  
Morphological Changes ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease

BACKGROUND: Identifying different phenotypes of chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease.OBJECTIVE: To characterize the phenotypes of COPD according to high-resolution computed tomography (HRCT) findings; and to correlate HRCT scores obtained using the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.METHODS: The present study included 80 consecutive patients with stable COPD. HRCT scans were evaluated by two independent radiologists according to the modified Bhalla scoring system.RESULTS: Fifty-four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements and higher levels of inflammation, and reported more exacerbations in the previous year compared with patients with no findings on HRCT. Patients with morphological changes were classified into one of three groups according to their HRCT phenotype(s): emphysema (E) only, E + bronchiectasis (B)/peribronchial thickening (PBT) or B/PBT only. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, C-reactive protein (CRP) levels and the number of exacerbations among the groups were significantly different. Pairwise comparisons between the E only and E+B/PBT groups showed significantly lower FVC, FEV1and FEV1/FVC values, and higher CRP levels and number of exacerbations compared with the B/PBT group. No significant differences were found between the E+B/PBT and the B/PBT groups. An inverse correlation was found between the total HRCT score and FVC, FEV1and FEV1/FVC; the correlation was positive with CRP level, erythrocyte sedimentation rate and number of exacerbations.CONCLUSION: The present study exposed the intimate relationship between phenotype(s) characterized by HRCT and scoring for morphological abnormalities; and clinical and functional parameters and inflammatory markers. The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in the management and prognosis of COPD patients.

scholarly journals Predictive Value of Serial High-Resolution Computed Tomography Analyses and Concurrent Lung Function Tests in Systemic Sclerosis

2015 ◽  
Vol 67 (8) ◽  
pp. 2205-2212 ◽  
Author(s):  
Anna-Maria Hoffmann-Vold ◽  
Trond M. Aaløkken ◽  
May Brit Lund ◽  
Torhild Garen ◽  
Øyvind Midtvedt ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Lung Function ◽  
Predictive Value ◽  
Lung Function Tests ◽  
High Resolution Computed Tomography ◽  
Function Tests

Pulmonary hypertension and systemic sclerosis: the role of high-resolution computed tomography

2013 ◽  
Vol 118 (8) ◽  
pp. 1360-1372 ◽  
Author(s):  
Maurizio Zompatori ◽  
Maria Barbara Leone ◽  
Marica Giannotta ◽  
Nazzareno Galiè ◽  
Massimiliano Palazzini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
High Resolution Computed Tomography

S162 – Chronic Aspiration after Supracricoid Partial Laryngectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P130-P131
Author(s):  
Andrea Gallo ◽  
Giovanni Ruoppolo ◽  
Marco Di Mario ◽  
Calcagno Paola ◽  
Manciocco Valentina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Case Series ◽  
Control Group ◽  
Chronic Obstructive ◽  
Partial Laryngectomy ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Supracricoid Partial Laryngectomy ◽  
Control Evaluation

Objectives The aim of this study is to evaluate the long-term swallowing status and the high resolution computed tomography (HRCT) pulmonary findings of chronic aspiration in patients who have undergone supracricoid partial laryngectomy (SCPL), to demonstrate that SCPL causes a mild and well-tolerated degree of chronic aspiration, allowing the patient to avoid a nothing-by-mouth status. Methods Retrospective medical record review. Cohort study. Case series. The follow-up period ranged from 3 to 13 years. 116 patients treated with SCPL were analyzed. The patients included in the study were NED, were followed for more than 3 years, were without tracheal cannula or nasogastric tube, and able to feed orally. A group of 20 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control. Evaluation of postoperative swallowing disorders included a careful observation of the patients by the physician, fiberoptic endoscopic evaluation of swallowing (FEES), and videofluoroscopy (VFS). Clinical grading of postoperative aspiration was assessed according to the Leipzig and Pearson scale. The radiological manifestations of chronic aspiration were recorded at high resolution computed tomography (HRCT). Results A higher incidence of pulmonary consolidation was found in the patients affected by postoperative chronic aspiration, compared to the control group (p<0.001). No significant differences were noted between the control group and the dysphagic group regarding the remaining radiological findings. Conclusions SCPL causes a mild and well-tolerated degree of chronic aspiration, determining low functional impairment and allows the patient a good quality of life.

scholarly journals The variation of respiration biomechanics and high resolution computed tomography indices when analyzing chronic obstructive lung disease

2011 ◽  
Vol 10 (1) ◽  
pp. 168-173
Author(s):  
E. V. Ekkardt ◽  
T. N. Bodrova ◽  
F. F. Tetenev ◽  
O. V. Rodionova ◽  
N. G. Ivanova
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Clinical Signs ◽  
Chronic Obstructive Lung Disease ◽  
Lung Ventilation ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Early Stages

The aim of the research was to determine how chronic obstructive lung disease clinical signs with lung ventilation function disturbance to various degrees correspond to respiration biomechanics and high resolution computed tomography indices. It was revealed that respiration biomechanics indices are changed at the early stages of chronic obstructive lung disease formation.

scholarly journals Pulmonary infections caused by non-tuberculous mycobacteria−single centre experience

2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 88-92
Author(s):  
Tatjana Adzic-Vukicevic ◽  
Ana Blanka ◽  
Marija Laban-Lazovic ◽  
Vesna Skodric-Trifunovic ◽  
Dajana Trifunovic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Clinical Importance ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Culture Methods ◽  
Radiographic Findings ◽  
Co Morbidity ◽  
The One ◽  
The Right

Introduction. Non-tuberculosis mycobacteria are environmental organisms found in soil and water worldwide, and an infection caused by non-tuberculosis mycobacteria is less frequently found than the one associated with Mycobacterium tuberculosis. This study was designed to evaluate data relating to non-tuberculosis mycobacteria in patients with clinical importance. Material and Methods. Of 12 patients (pts) admitted to the Department of Pulmonology, Clinical Centre of Serbia in Belgrade during 2010- 2011, seven (58.33%) were men and five (41.67%) were women. Bacteriological and radiographic findings, co?morbidity, treatment management and outcome were evaluated from medical records. Results. Using GenoType? Mycobacterium CM/AS (Hain Lifescience) assays for identification of isolated cultures of NTM) M.xenopi was found in six (50%) pts, M.avium complex in two (16.67%) pts, M.kansasii and M.xenopi in one (8.33%), M. gordone, M.abscessus and M.peregrinum in one (8.33%) patient each. Cavitary lesions were most frequently determined on high resolution computed tomography in five (41.67%) pts, followed with consolidation in two (16.67%) pts, cavitation with fibronodular lesions and bronchiectasis in one (8.33%) patient each. Comorbidities were noticed in nine (75%) pts, with chronic obstructive pulmonary diseases most frequently found in six (50%) pts. According to American Thoracic Society definition and criteria, treatment was administered in nine (75%) pts. Conclusion. In order to find the right treatment, it is important to identify non-tuberculosis mycobacteria lung infection by culture methods, at least two positive, accompanied with high resolution computed tomography changes.

Optimal Technique for Catheterizing the Pulmonary Arteries Without Dedicated Pulmonary Catheters

2018 ◽  
Author(s):  
George Carberry ◽  
Michael Brunner
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Computed Tomography Angiography ◽  
Femoral Vein ◽  
Pulmonary Arteries ◽  
High Resolution Computed Tomography ◽  
Pulmonary Arteriography ◽  
Pulmonary Artery Catheters ◽  
Diagnostic Catheter

With the emergence of high-resolution computed tomography angiography, the number of transcatheter pulmonary arteriograms being performed has steeply declined. For this reason, many interventional departments no longer stock dedicated pulmonary artery catheters such as the pre-shaped 7 Fr Grollman catheter for a femoral vein approach. Interventionalists are therefore required to improvise with catheters that are available on hand. Transcatheter pulmonary arteriography may be indicated when dedicated pulmonary artery catheters are not available for use. In this chapter, a step-by-step approach is described and accompanied by illustrations demonstrating how a common diagnostic catheter, the 5 Fr Omniflush catheter, can be used to perform pulmonary arteriography.

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