Assessment of Perfusion Pattern and Extent of Perfusion Defect on Dual-Energy CT Angiography: Correlations between the Causes of Pulmonary Hypertension and Vascular Parameters

• Published in: Korean Journal of Radiology Vol. 15; no. 2; pp. 286 - 294
• Main Authors: Kim, Eun Young, Seo, Joon Beom, Oh, Sang Young, Lee, Choong Wook, Hwang, Hye Jeon, Lee, Sang Min, Lee, Young Kyung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 2014; 대한영상의학회
• Subjects: Adult; Aged; Aged, 80 and over; Aorta; Aorta - physiopathology; Aortography; Cardiac catheterization; Chronic obstructive pulmonary disease; Coronary vessels; Energy; Female; Heart; Humans; Hypertension, Pulmonary; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - physiopathology; Intubation; Iodine; Lung diseases; Male; Medical imaging; Middle Aged; Pulmonary arteries; Pulmonary Artery; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; Pulmonary Circulation; Pulmonary Circulation - physiology; Pulmonary hypertension; Retrospective Studies; Scintigraphy; Software; Thoracic Imaging; Thromboembolism; Tomography, X-Ray Computed; Tomography, X-Ray Computed - methods; Tricuspid Valve Insufficiency; Tricuspid Valve Insufficiency - diagnostic imaging; Tricuspid Valve Insufficiency - physiopathology; Work stations; Young Adult; 방사선과학; Germany; Dual-energy CT; Pulmonary hypertension; Pulmonary perfusion
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2014.15.2.286

To assess perfusion patterns on a dual-energy pulmonary CT angiography (DECTA) of pulmonary hypertension (PHT) with variable causes and to assess whether the extent of perfusion defect can be used in the severity assessment of PHT. Between March 2007 and February 2011, DECTA scans of 62 consecutive patients (24 men, 38 women; mean age, 58.5 ± 17.3 [standard deviation] years; range, 19-87 years) with PHT were retrospectively included with following inclusion criteria; 1) absence of acute pulmonary thromboembolism, 2) maximal velocity of tricuspid regurgitation jet (TR Vmax) above 3 m/s on echocardiography performed within one week of the DECTA study. Perfusion patterns of iodine map were divided into normal (NL), diffuse heterogeneously decreased (DH), multifocal geographic and multiple peripheral wedging patterns. The extent of perfusion defects (PD), the diameter of main pulmonary artery (MPA) and the ratio of ascending aorta diameter/MPA (aortopulmonary ratio, APR) were measured. Pearson correlation analysis was performed between TR Vmax on echocardiography and CT imaging parameters. Common perfusion patterns of primary PHT were DH (n = 15) and NL (n = 12). The perfusion patterns of secondary PHT were variable. On the correlation analysis, in primary PHT, TR Vmax significantly correlated with PD, MPA and APR (r = 0.52, r = 0.40, r = -0.50, respectively, all p < 0.05). In secondary PHT, TR Vmax significantly correlated with PD and MPA (r = 0.38, r = 0.53, respectively, all p < 0.05). Different perfusion patterns are observed on DECTA of PHT according to the causes. PD and MPA are significantly correlated with the TR Vmax.