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Keywords:
Cardiovascular system, Pulmonary vessels, CT, CT-Angiography, CT-High Resolution, Computer Applications-3D, Computer Applications-Detection, diagnosis, Outcomes, Hypertension
Authors:
S. Terpenning1, L. Ketai1, C. T. Lin2, S. J. Kiglerman2, J. Jeudy2; 1Albuquerque, NM/US, 2Baltimore, MD/US
DOI:
10.1594/ecr2015/C-0732
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 between normal controls and patients with pulmonary HTN (Fig. 3).
Using 3.15 cm main MPA diameter as a threshold,
reader sensitivities for PHTN were 76%,
74% and 74 % and specificities of 60 %,
62% and 71%) Areas under the ROC curves were similar for all three readers and per-case inter-rater agreement was good,
kappa values > 0.65 (Fig. 4). Body surface area did not differ between false positive (2.1± 0.4) and true negative patients (2.0±0.3).
ROC curves for RPA (Fig. 5) or LPA (Fig. 6) size demonstrated smaller areas under the curves for all readers and incorporation of RPA or LPA diameter > 2.2 cm to detect PHTN increased the sensitivities to 90%,
90% and 94% but degraded specificities to 36%,
29% and 33%.
Neither the distance from the measured MPA to the pulmonary artery bifurcation nor the measured size of MPA differed significantly among 3 radiologists (p-value=0.65 and 0.76 respectively).