title: Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD.
abstract: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD.
  
  
  
  COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.
  
  
  
  Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24).
  
  
  
  A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508, Utrecht, The Netherlands. fmohamedhoesein@gmail.com.
authors.forename: Firdaus A
authors.initials: FA
authors.lastname: Mohamed Hoesein
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Besselink
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Pompe
authors.affiliation: Department of Respiratory Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Erik-Jan
authors.initials: EJ
authors.lastname: Oudijk
authors.affiliation: Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ed A
authors.initials: EA
authors.lastname: de Graaf
authors.affiliation: Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Kwakkel-van Erp
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508, Utrecht, The Netherlands.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Luijk
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging* / Q000473:pathology*; D062186:Arterial Pressure; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: COPD; Pulmonary circulation and pulmonary hypertension; Radiology and other imaging