title: Pulmonary veno-occlusive disease: the role of CT.
abstract: OBJECTIVE
  The authors sought to evaluate the diagnostic accuracy of high-resolution computed tomography (HRCT) in the detection of pulmonary veno-occlusive disease (PVOD) in patients with pre-capillary pulmonary arterial hypertension (PAH) of unknown aetiology, and to identify the role of CT in diagnosis and therapy.
  
  
  METHODS
  The CT scans of 96 patients were retrospectively reviewed and assessed for specific HRCT findings: ground-glass opacities, septal lines and mediastinal lymph nodal enlargement (short diameter ≥1 cm). According to the HRCT findings, patients were divided into PVOD-suspicious and not PVOD-suspicious. Subsequently, a clinical-instrumental evaluation was performed, and the response to therapy and histopathological reports were evaluated.
  
  
  RESULTS
  Radiological evaluation based on HRCT findings revealed 29 patients as PVOD-suspicious and 67 as not PVOD-suspicious. The final diagnosis was PVOD in 22 patients and idiopathic PAH in 74 patients. The CT scan showed 95.5 % sensitivity, 89% specificity, 72.5% positive predictive value, and 98.5% negative predictive value, with a diagnostic accuracy of 90.5% in identifying patients with PVOD.
  
  
  CONCLUSIONS
  Chest CT can be considered a screening test in the assessment of patients with PAH of unknown aetiology, and the radiologist can help the clinician to identify patients with CT findings that make PVOD highly probable.
authors.affiliation: U.O. Radiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero Universitaria, Policlinico Sant' Orsola-Malpighi, Bologna, Italy, giangasparemineo@alice.it.
authors.forename: Giangaspare
authors.initials: G
authors.lastname: Mineo
authors.forename: Domenico
authors.initials: D
authors.lastname: Attinà
authors.forename: Martina
authors.initials: M
authors.lastname: Mughetti
authors.forename: Caterina
authors.initials: C
authors.lastname: Balacchi
authors.forename: Fiorella
authors.initials: F
authors.lastname: De Luca
authors.forename: Fabio
authors.initials: F
authors.lastname: Niro
authors.forename: Federica
authors.initials: F
authors.lastname: Ciccarese
authors.forename: Luigi
authors.initials: L
authors.lastname: Lovato
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Francesco
authors.initials: F
authors.lastname: Buia
authors.forename: Cecilia
authors.initials: C
authors.lastname: Modolon
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manes
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Palazzini
authors.forename: Nazareno
authors.initials: N
authors.lastname: Galiè
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011668:Pulmonary Veno-Occlusive Disease / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed