Korean J Radiol.  2014 Apr;15(2):286-294. 10.3348/kjr.2014.15.2.286.

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

• Kim EY
• Seo JB
• Oh SY
• Lee CW
• Hwang HJ
• Lee SM
• Lee YK

• KMID: 1705585
• DOI: http://doi.org/10.3348/kjr.2014.15.2.286

Abstract

OBJECTIVE
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.
MATERIALS AND METHODS
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.
RESULTS
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).
CONCLUSION
Different perfusion patterns are observed on DECTA of PHT according to the causes. PD and MPA are significantly correlated with the TR Vmax.

Keyword

Pulmonary hypertension; Dual-energy CT; Pulmonary perfusion

MeSH Terms

Adult
Aged
Aged, 80 and over
Aorta/physiopathology
Aortography
Female
Humans
Hypertension, Pulmonary/physiopathology/*radiography
Male
Middle Aged
Pulmonary Artery/physiopathology/*radiography
Pulmonary Circulation/physiology
Retrospective Studies
Tomography, X-Ray Computed/*methods
Tricuspid Valve Insufficiency/physiopathology/radiography
Young Adult