title: CT-based pulmonary artery measurements for the assessment of pulmonary hypertension.
abstract: OBJECTIVE
  Pulmonary hypertension (PH) is a complex and fatal disease that is difficult to diagnose noninvasively. This study evaluated previously published computed tomography-based vessel measurement criteria and investigated the predictive power and diagnostic ability of the main pulmonary artery diameter (MPAD) and the ratio of MPAD to aorta diameter (rPA).
  
  
  METHODS
  The database for this study consisted of 175 PH patients (for whom mean pulmonary artery pressure [mPAP] was known), 16 patients without PH but with known mPAP (non-PH patients), and 114 "normal" patients without known mPAP. The performance of previously published criteria, MPAD > 29 mm and rPA > 1, was determined. The relationship between vessel measurements and mPAP was evaluated through correlation and linear regression analysis. The ability of these measurements to discriminate between patients with and without PH was determined by receiver operating characteristic analysis.
  
  
  RESULTS
  For discriminating between PH and "normal" patients, the sensitivity and specificity of the criterion MPAD > 29 mm were 0.89 (0.84-0.93) and 0.83 (0.76-0.90), respectively, and the sensitivity and specificity of the criterion rPA > 1 were 0.89 (0.85-0.94) and 0.82 (0.74-0.89), respectively. At a specificity of 0.95 in the task of separating PH and "normal" patients, the sensitivity of MPAD was 0.81 (0.72-0.90) and the sensitivity of rPA was 0.76 (0.66-0.85), but the specificity for both decreased when non-PH patients were included. For the combined PH and non-PH patient groups, the correlation between the vessel measurements and mPAP was significant but low, and the ability of the vessel measurements to predict mPAP was limited.
  
  
  CONCLUSIONS
  This study found that the sensitivity of previously published vessel criteria for identifying PH patients is high, but the specificity may not be high enough for routine use in a clinical patient population.
authors.affiliation: Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
authors.forename: Neal
authors.initials: N
authors.lastname: Corson
authors.affiliation: Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637. Electronic address: s-armato@uchicago.edu.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Armato
authors.affiliation: Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
authors.forename: Zacariah E
authors.initials: ZE
authors.lastname: Labby
authors.affiliation: Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
authors.forename: Christopher
authors.initials: C
authors.lastname: Straus
authors.affiliation: Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
authors.forename: Adam
authors.initials: A
authors.lastname: Starkey
authors.affiliation: Department of Medicine, The University of Chicago, 5841 S. Maryland Ave., MC 5403, Chicago, IL 60637.
authors.forename: Mardi
authors.initials: M
authors.lastname: Gomberg-Maitland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Pulmonary hypertension; pulmonary arterial hypertension; pulmonary arterial pressure; pulmonary artery diameter; vessel measurement