Aims and objectives
Main pulmonary artery (MPA) measurement has shown to have a wide range of variability among the radiologists.
Main pulmonary artery (MPA) diameter greater than 3 cm is commonly used to diagnose pulmonary hypertension (PHTN) (1) on Computed Tomography (CT) of the chest,
however there is substantial overlap between normal subjects and patients with pulmonary artery hypertension based on the size of main pulmonary artery alone.
Clinical practice suggests that the specificity of this measurement is low and reader variability may be high.
It is uncertain...
Methods and materials
The study was approved by the IRB and the informed consent was waived.
Subject selection
We divided the patients into 2 groups,
normal pulmonary artery pressure (< or = 25 mmHg) and pulmonary hypertension (>25 mmHg),
based on the mean pulmonary artery pressure (2) documented from right heart catheterization performed by the University of Maryland cardiology service between January 2010 and December 2012.
Patients with prior cardiac surgery,
congenital heart disease,
pericardial disease,
severe lung disease and critically ill patients documented on CT examinations were...
Results
Demographics
None of the demographic data or patients’ factors were related to the size of MPAD.
There is no significant relationship between the gender and MPAD of 45 patients (16 females and 29 males) with normal pulmonary artery pressure (p-value=0.17) or 50 patients (22 females and 28 males) with PHTN (p-value=0.16).
Pulmonary Artery measurements
The distribution of the main pulmonary artery diameter was normal in both groups (Fig. 2)(p=0.71 for normal PAP patients and 0.67 for PHTN patients by Shapiro-Wilk test).
There was extensive overlap...
Conclusion
MPAD in our study has normal distribution similar to Shirin and Sinem et al (3,4).
We did not find any correlation between patient’s demographic data or patient factors and the size of MPA while prior works have shown mixed results.
Previously published data had shown that pulmonary artery pressure,
patient’s age,
height,
weight and BSA were correlated with the size of main pulmonary artery while the patient’s gender was not.
(4-8).
There is no statistical significance among 3 radiologists with different years of experience in...
Personal information
Silanath Terpenning: An assistant professor at the department of radiology,
division of cardiothoracic imaging,
University of New Mexico,
Albuquerque,
NM,
USA.
Loren H Ketai: A professor at the department of radiology University of New Mexico,
division of cardiothoracic imaging,
Albuquerque,
NM,
USA
Cheng Tin Lin: An assistant professor at the department of radiology,
The Johns Hopkins University,
division of cardiothoracic imaging,
Baltimore,
MD,
USA
Seth J Kligerman: An assistant professor at the department of radiology,
division of cardiothoracic imaging,
Unviersity of Maryland,
Baltimore,
MD,
USA...
References
1.
Rigmor Lundby,
Svend Rand-Hendriksen,
John K.
Hald,
Are Hugo Pripp,
Hans-Jorgen Smith.
The pulmonary artery in patients with Marfan syndrome: a cross-sectional study.
Genet Med.
2012(11);922-927.
2.
Nazzareno Galie,
Marius M.
Hoeper,
Marc Humbert ,
Adam Torbicki,
Jean-Luc Vachiery,
Joan Albert Barbera et al.
Guidelines for the diagnosis and treatment of pulmonary hypertension. The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS),
endorsed by the International Society of Heart...