title: Pulmonary Artery Imaging in Patients with Chronic Thromboembolic Pulmonary Hypertension: Comparison of Cone-Beam CT and 64-Row Multidetector CT.
abstract: OBJECTIVE
  To compare the depiction of pulmonary arteries in pulmonary arterial catheter-based contrast-enhanced cone-beam CT with peripheral intravenous contrast-enhanced multidetector CT in patients with suspected chronic thromboembolic pulmonary hypertension.
  
  
  METHODS
  In 20 patients (15 men and 5 women, 63.4 y ± 16.3), cone-beam CT using a catheter placed in the main pulmonary artery and 64-row multidetector CT using an appropriate venous access were performed. Contrast enhancement was measured in the main pulmonary artery, the right and left pulmonary arteries, and the left atrium. The amount of peripheral vessel conspicuity adjacent to the pleural surface (distance from vessel-to pleura) was measured. Two readers (R1, R2) independently evaluated the pulmonary arteries for image quality and pathologic findings in both modalities.
  
  
  RESULTS
  Contrast density was higher in the main pulmonary artery and right and left pulmonary arteries (P < .002) and lower in the left atrium (P = .001) on cone-beam CT. The smallest distance between clearly delineated vessels and the pleura was significantly lower on cone-beam CT images (P < .0001). Interobserver agreement was good for cone-beam CT (κ = 0.79) and multidetector CT (κ = 0.78), whereas intermodality agreement was moderate (R1, κ = 0.60; R2, κ = 0.59). Both readers detected more weblike stenoses with cone-beam CT (76; 22%) compared with multidetector CT (25; 7%).
  
  
  CONCLUSIONS
  Cone-beam CT shows improved contrast between pulmonary arteries and the left atrium and allows a more detailed depiction of the pulmonary arteries.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany. Electronic address: hinrichs.jan@mh-hannover.de.
authors.forename: Jan B
authors.initials: JB
authors.lastname: Hinrichs
authors.affiliation: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: von Falck
authors.affiliation: Clinic for Pneumology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Marius M
authors.initials: MM
authors.lastname: Hoeper
authors.affiliation: Clinic for Pneumology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Olsson
authors.affiliation: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Frank K
authors.initials: FK
authors.lastname: Wacker
authors.affiliation: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Bernhard C
authors.initials: BC
authors.lastname: Meyer
authors.affiliation: Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research, Hannover Medical School, Hannover, Germany.
authors.forename: Julius
authors.initials: J
authors.lastname: Renne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000072226:Computed Tomography Angiography / Q000379:methods*; D054893:Cone-Beam Computed Tomography; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000209:etiology; D007262:Infusions, Intravenous; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D007479:Iopamidol / Q000008:administration & dosage / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; C057937:iomeprol; C093233:iobitridol; D007472:Iohexol; D007479:Iopamidol