Characterization of the pulmonary circulation according to hemodynamic changes by computed tomography.
Increased or decreased pulmonary blood flow (PBF) and an increased pulmonary vascular resistance (PVR), represent common and important change in pulmonary hemodynamics. In this study, we constructed 3 hemodynamic models in 5 dogs, that is, an increased and a decreased PBF model, and an increased PVR model. A CT perfusion scan was performed in each hemodynamic model. Perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT), and maximal slope (MS) were calculated automatically by specialized software and analyzed for changes according to hemodynamic status. In terms of the normal state, blood flow was affected by gravity and dependent area showed higher BF and BV and lower MS and MTT than the non-dependent area. The decreased PBF model showed a significant increase in BF and MS (p=0.046, 0.005) but no significant change in BV (p > 0.05), and a slight elongation of MTT (p > 0.05) versus the normal state. The increased PBF model showed a slightly increased BV and a slightly decreased MTT (p > 0.05). The increased PVR model showed significant reduction in BF, BV, and MS (p < 0.000, 0.007, 0.000) and a slight increase in MTT, but without statistical significance (p > 0.05). However, it was noticeable that the distribution of MTT with respect to gravity in the normal lung was completely reversed in the increased PVR model. In conclusion, based on our understanding of perfusion characteristic in normal state, abnormal regional hemodynamic changes in the lung can be detected and evaluated. Predicting changes in pulmonary vascular resistance should be possible by a thorough analysis of CT perfusion parameters.
Choi
Byoung Wook
BW
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
Choe
Kyu Ok
KO
Kim
Hee-Joung
HJ
Cho
Bum Koo
BK
Chung
Kyung Young
KY
Kim
Se Kyu
SK
Kim
Bong Kyung
BK
Yang
In Sook
IS
D000818:Animals; D004285:Dogs; D006439:Hemodynamics; D011652:Pulmonary Circulation; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed