Investigating Patients with Pulmonary Hypertension Under Detector-Based Spectral Computed Tomography

Area of Science:

• Radiology
• Medical Imaging
• Cardiopulmonary Diseases

Background:

• Pulmonary hypertension (PH) involves elevated pulmonary artery pressure.
• Dual-energy CT (DECT) research often overlooks lung parenchyma in PH, focusing instead on pulmonary embolism iodine mapping.
• Parametric mapping of lung parenchyma in PH using DECT requires further investigation.

Purpose of the Study:

• To evaluate the utility of iodine density (Iod) and effective atomic number (Zeff) from DECT in diagnosing and characterizing PH and CTEPH.
• To compare DECT-derived parameters between PH patients and controls.
• To differentiate between chronic thromboembolic PH (CTEPH) and non-CTEPH cases using DECT.

Main Methods:

• 156 thoracic DECT scans were analyzed.
• Iodine density (Iod) and effective atomic number (Zeff) were measured in lung parenchyma and major vessels (pulmonary artery, aorta).
• Parameters were compared between PH and control groups, and between CTEPH and non-CTEPH subgroups.

Main Results:

• Lower region of interest (ROI)-Zeff was observed in PH patients compared to controls.
• The ratio of pulmonary artery (PA)-iodine density to ROI-iodine density was higher in PH patients.
• CTEPH cases showed lower ROI-iodine density and higher PA-iodine density/ROI-iodine density ratios than non-CTEPH cases.

Conclusions:

• DECT-derived pulmonary artery iodine density and effective atomic number (Zeff) are valuable for diagnosing PH.
• These parameters aid in characterizing PH, particularly in differentiating CTEPH.
• Spectrum CT parametric mapping offers a novel approach for PH assessment.