Unenhanced computed tomography as a diagnostic tool in suspected pulmonary hypertension: a retrospective cross-sectional pilot study

作者：Ze Ming Goh, Christopher S. Johns, Tarik Julius, Samuel Barnes, Krit Dwivedi, Charlie Elliot, Michael Sharkey, Dheyaa Alkanfar, Thanos Charalampololous, Catherine Hill, Smitha Rajaram, Robin Condliffe, David G. Kiely, Andrew J. Swift · 发表于：Wellcome Open Research · 年份：2021 · DOI：10.12688/wellcomeopenres.16853.1 · 被引用次数：4 · 研究领域：Pulmonary Hypertension Research and Treatments、Cardiovascular Function and Risk Factors、Liver Disease and Transplantation

Background: Computed tomography pulmonary angiography (CTPA) has been proposed to be diagnostic for pulmonary hypertension (PH) in multiple studies. However, the utility of the unenhanced CT measurements diagnosing PH has not been fully assessed. This study aimed to assess the diagnostic utility and reproducibility of cardiac and great vessel parameters on unenhanced computed tomography (CT) in suspected pulmonary hypertension (PH). Methods: In total, 42 patients with suspected PH who underwent unenhanced CT thorax and right heart catheterization (RHC) were included in the study. Three observers (a consultant radiologist, a specialist registrar in radiology, and a medical student) measured the parameters by using unenhanced CT. Diagnostic accuracy of the parameters was assessed by area under the receiver operating characteristic curve (AUC). Inter-observer variability between the consultant radiologist (primary observer) and the two secondary observers was determined by intra-class correlation analysis (ICC). Results: Overall, 35 patients were diagnosed with PH by RHC while 7 patients were not. Main pulmonary arterial (MPA) diameter was the strongest (AUC 0.79 to 0.87) and the most reproducible great vessel parameter. ICC comparing the MPA diameter measurement of the consultant radiologist to the specialist registrar’s and the medical student’s were 0.96 and 0.92, respectively. Right atrial area was the cardiac measurement with highest accuracy and reproducib...