Ces radiol. 2014, 68(4):273-281

Pulmonary hypertension evaluation on chest radiograph and HRCT of the lungs in patients with chronic pulmonary diseaseOriginal article

Jan Brožík1,2, Vladimír Bartoš3, Eva Kočová1, Leo Steinhart1, Martin Slanina1, Pavel Eliáš1
1 Radiologická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Hradec Králové
2 Radiology Department, Glenfield Hospital, University Hospitals of Leicester, Groby Rd, Leicester LE3 9QP, Velká Británie
3 Plicní klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice, Hradec Králové

Aim: To evaluate relationship between selected parameters and mean pulmonary artery pressure (mPAP). To assess prediction of pulmonary hypertension (PH) on chest radiographs (CXR) and High-resolution CT (HRCT) of lungs.

Methods: 53 individuals with chronic lung disease underwent right heart cathetrisation, CXR and HRCT. 30 patients had PH confirmed. CXRs and HRCTs were reviewed by three radiologist who besides evaluation of findings stated whether PH is present. Relation between relevant parameters and mPAP and agreement between radiologists and real presence of PH were assessed.

Results: The strongest correlation on CXR was found between mPAP and ratio of right descending pulmonary artery width and the left main bronchus (r = 0.256650, p = 0.02048) and right descending branch of pulmonary artery width (r = 0.188897, p = 0.023362). The strongest correlation on CXR was found between mPAP and pulmonary artery diameter (r = 0.396894, p = 0.000001) and PA/AA ratio (r = 0.382652, p = 0.000002. The cut-off value for PH for PA width was 31,2 mm with specificity 80.769% and sensitivity 68,182%. Agreement between radiologists and value of mPAP was in CXRS 58.49%, 54.72% and 64.15%, in HRCT of the lungs 70.83%, 60.42% and 62.50%.

Conclusion: Width of pulmonary arteries and mPAP are related. If specific imaging findings are present, PH can be suspected, if absent the PH can be ruled out with high likelihood.

Keywords: chest X-ray, High-resolution CT, lung disease, interobserver agreement, pulmonary hypertension

Accepted: September 15, 2014; Published: December 1, 2014  Show citation

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Brožík J, Bartoš V, Kočová E, Steinhart L, Slanina M, Eliáš P. Pulmonary hypertension evaluation on chest radiograph and HRCT of the lungs in patients with chronic pulmonary disease. Ces radiol. 2014;68(4):273-281.
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