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Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary
Yoel Siegel1, Drew Bleicher, Michael Kurt Gordon
1From the University of Miami School of Medicine, Jackson Memorial Hospital, Miami, FL.
Journal of Computer Assisted Tomography
|February 28, 2017
Summary
Dynamic computed tomography pulmonary angiography (CTPA) parameters, specifically time to trigger (TT), correlate with pulmonary hypertension (PH). This novel approach shows potential for PH screening and differentiating etiologies.
Area of Science:
- Radiology and Imaging
- Cardiovascular Medicine
- Pulmonary Medicine
Background:
- Pulmonary hypertension (PH) presents with diverse pathophysiologies.
- Computed tomography pulmonary angiography (CTPA) is used in PH workup, but dynamic parameters are underutilized.
- Static CTPA measurements correlate with PH, yet dynamic assessments offer new insights.
Purpose of the Study:
- To investigate the correlation between dynamic CTPA parameters and PH.
- To determine if dynamic CTPA parameters differ across various PH etiologies.
- To propose a CTPA-based screening method for PH.
Main Methods:
- Retrospective analysis of patients undergoing both right-heart catheterization and CTPA within 45 days.
- Recording and analysis of time to trigger (TT) during CTPA bolus tracking.
- Comparison of TT values with pulmonary artery pressures from catheterization; assessment of TT's sensitivity and specificity for PH.
Main Results:
- A significant correlation was observed between pulmonary pressure and TT (P < 0.01).
- TT also correlated significantly with reduced right ventricular function (P < 0.01).
- Left heart failure exhibited the longest TT, impacting patients with PH and RV dysfunction.
Conclusions:
- Dynamic CTPA flow parameters, particularly TT, significantly correlate with pulmonary pressure, aiding PH screening.
- Left heart failure demonstrates a notable influence on TT in PH patients.
- Dynamic CTPA parameters offer a promising, non-invasive tool for PH assessment.
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