title: Non-invasive determination of pulmonary hypertension with dynamic contrast-enhanced computed tomography: a pilot study.
abstract: OBJECTIVE
  In this pilot study we explored whether contrast-material bolus propagation time and speed in the pulmonary arteries (PAs) determined by dynamic contrast-enhanced computed tomography (DCE-CT) can distinguish between patients with and without pulmonary hypertension (PH).
  
  
  METHODS
  Twenty-three patients (18 with and 5 without PH) were examined with a DCE-CT sequence following their diagnostic or follow-up right-sided heart catheterisation (RHC). X-ray attenuation over time curves were recorded for regions of interest in the main, right and left PA and fitted with a spline fit. Contrast material bolus propagation speeds and time differences between the peak concentrations were compared with haemodynamic parameters from RHC.
  
  
  RESULTS
  Bolus speed correlated (ρ = -0.55) with mean pulmonary arterial pressure (mPAP) and showed a good discriminative power between patients with and without PH (cut-off speed 317 mm/s; sensitivity 100%/specificity 100%). Additionally, time differences between peaks correlated with mPAP (ρ = 0.64 and 0.49 for right and left PA, respectively) and discrimination was achieved with sensitivity 100%/specificity 100% (cut-off time 0.15 s) and sensitivity 93 %/specificity 80% (cut-off time 0.45 s), respectively.
  
  
  CONCLUSIONS
  Bolus propagation speed and time differences between contrast material peaks in the PA can identify PH. This method could be used to confirm the indication for RHC in patients screened for pulmonary hypertension.
  
  
  CONCLUSIONS
  • Dynamic contrast-enhanced computed tomography (CT) can identify patients with pulmonary hypertension. • Bolus propagation speed in the pulmonary artery is reduced in pulmonary hypertension. • Peak-contrast propagation times provide a practical surrogate for speed. • This non-invasive technique could serve as a screening method for pulmonary hypertension. • Invasive right-sided heart catheterisations might be restricted to a smaller group of patients.
authors: Ludwig Boltzmann Institute for Lung Vascular Research, Stiftingtalstrasse 24, 8010, Graz, Austria.
authors: Michael
authors: M
authors: Pienn
authors: Gabor
authors: G
authors: Kovacs
authors: Maria
authors: M
authors: Tscherner
authors: Alexander
authors: A
authors: Avian
authors: Thorsten R
authors: TR
authors: Johnson
authors: Peter
authors: P
authors: Kullnig
authors: Rudolf
authors: R
authors: Stollberger
authors: Andrea
authors: A
authors: Olschewski
authors: Horst
authors: H
authors: Olschewski
authors: Zoltán
authors: Z
authors: Bálint
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D003287:Contrast Media; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media