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Dual energy CT based scoring in chronic thromboembolic pulmonary hypertension and correlation with clinical and

Mostafa Abozeed1, Sofija Conic1, Jennifer Bullen2

  • 1Sections of Thoracic and Cardiovascular Imaging Laboratory, Imaging Institute, Cleveland Clinic, OH, USA.

Cardiovascular Diagnosis and Therapy
|July 8, 2022
PubMed

Insights

Dual energy CT scoring in chronic thromboembolic pulmonary hypertension (CTEPH) is feasible. This scoring system positively correlates with pulmonary arterial pressure and pulmonary vascular resistance, with the combined score showing the strongest correlation.

Area of Science:

  • Radiology
  • Cardiology
  • Pulmonology

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) is a significant clinical challenge.
  • Accurate assessment of disease severity is crucial for patient management.
  • Dual energy computed tomography (DECT) offers advanced imaging capabilities for evaluating CTEPH.

Purpose of the Study:

  • To develop and validate a DECT-based scoring system for CTEPH.
  • To correlate DECT scores with functional and hemodynamic parameters in CTEPH patients.
  • To assess the feasibility and reliability of DECT scoring in clinical practice.

Main Methods:

  • Retrospective analysis of 78 CTEPH patients who underwent DECT.
  • Calculation of clot burden score based on anatomical distribution of thrombi.
  • Calculation of perfusion defect (PD) score and a combined score (clot burden + PD).
  • Correlation of DECT scores with NYHA class, 6MWT, FEV1, FVC, DLCO, and hemodynamic parameters (PAP, PVR, RAP, CO, CI).

Main Results:

  • Clot burden, PD, and combined scores showed positive correlations with systolic, diastolic, and mean pulmonary arterial pressure (sPAP, dPAP, mPAP).
  • All three DECT scores positively correlated with pulmonary vascular resistance (PVR).
  • No statistically significant correlations were found between DECT scores and functional parameters like 6-minute walk distance (6MWT) or FEV1, FVC, and DLCO.

Conclusions:

  • DECT-based scoring is a feasible method for assessing CTEPH.
  • The developed scoring system correlates positively with key hemodynamic parameters (sPAP, mPAP, PVR).
  • The combined DECT score demonstrated the highest correlation magnitude, suggesting its potential utility in clinical evaluation.
Abstract

Keywords:
Pulmonary embolism (PE)multidetector computed tomographypulmonary hypertension (PH)

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