title: [Diagnostic value of CT pulmonary artery imaging for idiopathic pulmonary artery hypertension].
abstract: OBJECTIVE
  To evaluate the diagnostic value of CT pulmonary artery (CTPA) imaging with idiopathic pulmonary artery hypertension (IPAH).
  
  
  METHODS
  A total of 20 patients with right heart catheterization (RHC) proven IPAH were retrospectively analyzed between January 2012 and November 2015.The imaging was analyzed including pulmonary parenchyma, pulmonary interstitial, mediastinal lymph nodes, pericardium and pleural cavity on the CTPA examination.Cardiovascular parameters were measured in CTPA including right ventricle biggest short axis diameter (RVD), left ventricle biggest short axis diameter (LVD), main pulmonary artery diameter (MPAD), right pulmonary artery diameter (RPAD), left pulmonary artery diameter (LPAD), right low pulmonary artery diameter (RLPAD), ascending aorta diameter (AAD) and descending aorta diameter (DAD), and parameters were calculated including the ratio of the main pulmonary and ascending aorta diameter (rPA), the ratio of the ascending and descending aorta diameter (rAD), the ratio of the right ventricular and left ventricular short axis diameter (RV/LV). The relationship between sex, pulmonary, lymph nodes, pericardium, pleural and pulmonary arrery pressure (PAP) was analyzed by Spearman rank correlation analysis.All the parameters between mild-moderate (4 cases) and severe (16 cases) PAH were analyzed by independent sample t test.PAP of different age (<50 years and≥50 years) groups was analyzed by Pearson correlation analysis.
  
  
  RESULTS
  Of 20 cases, 7 cases showed patch exudative change, 5 cases showed"mosaic pattern"inhomogeneous perfusion, 3 cases displayed ill-defined centrilobular nodules, 6 cases manifested mediastinal lymphadenopathy, 10 cases had pericardial effusion including 4 cases of pleural effusion, 4 cases of dilated bronchial artery, 1 cases of secondary right pulmonary artery embolism.When comparing the presence or absence of pleural effusion, these was statistical difference of PAP (r=0.445, P=0.049). LVD, LPAD, RPAD, AAD, DAD and rPA were statistically different between mild-moderate and severe PAH (t values were 3.194, -3.393, -7.771, 10.299, 11.394 and -12.715, respectively, P<0.05). PAP was statistically different between different age groups (r=-0.481, P=0.032).
  
  
  CONCLUSIONS
  CTPA is a very important examination for the diagnosis of IPAH.The changes of lung, mediastinum, percardium, pleural cavity and the cardiovascular parameters can help diognose and evaluate IPAH.
authors.affiliation: Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Junliang
authors.initials: J
authors.lastname: Xu
authors.forename: Ruzhi
authors.initials: R
authors.lastname: Cai
authors.forename: Houyun
authors.initials: H
authors.lastname: Xu
authors.forename: Hongjie
authors.initials: H
authors.lastname: Hu
mesh_terms: D001011:Aorta; D006328:Cardiac Catheterization; D065627:Familial Primary Pulmonary Hypertension; D006352:Heart Ventricles; D006801:Humans; D008198:Lymph Nodes; D008206:Lymphatic Diseases; D008477:Mediastinal Diseases; D010490:Pericardial Effusion; D010996:Pleural Effusion; D011651:Pulmonary Artery; D011655:Pulmonary Embolism; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed