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

Background: Pulmonary hypertension (PH) is characterized by elevated pressure in the pulmonary artery. Currently, most dual-energy CT (DECT) research focuses on the application of iodine mapping in pulmonary embolism. However, little attention is paid to the parametric mapping of the lung parenchyma of PH. Methods: In total, 156 cases undergoing thoracic DECT from 2021 August to 2023 February were surveyed. For each case, the iodine density (Iod) and effective atomic number (Zeff) of four different levels of the lung, along with the iodine density of the pulmonary artery and aorta, were measured. The measured parameters and their derivatives were compared between PH cases and normal controls and between chronic thromboembolic PH (CTEPH) and non-CTEPH cases. Results: Region of interest (ROI)-Zeff was statistically lower in the PH group as compared to the normal controls on each level. The ratio of PA-iod/ROI-iod was significantly higher in the PH group than in the normal controls. ROI-iod was statistically lower in the CTEPH cases as compared with the non-CTEPH cases on each level. The CTEPH cases demonstrated a higher PA-iod/ROI-iod value as compared with the non-CTEPH cases. Conclusions: The PA-iodine density and effective Z of spectrum CT could serve as valuable imaging parameters for the diagnosis and characterization of PH and CTEPH.