Universität zu Köln

Kroeger, Jan Robert, Gerhardt, Felix, Dumitrescu, Daniel, Rosenkranz, Stephan, Schmidt, Matthias, Maintz, David and Bunck, Alexander C. (2019). Diagnosis of pulmonary hypertension using spectral-detector CT. Int. J. Cardiol., 285. S. 80 - 86. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

Full text not available from this repository.

Abstract

Objectives: To evaluate the value of spectral-detector CT (SDCT) in the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH), its differentiation against other etiologies of pulmonary hypertension (PH) and in the prediction of disease severity. Materials and methods: 60 patients with suspected PH underwent SDCT. Additional diagnostic tests in accordance with the ESC guidelines including right heart catherization and VQ-SPECT were performed. After full diagnostic work-up patients were classified as: 21 precapillary PH, 5 postcapillary PH, 6 combined pre- and postcapillary PH, 19 CTEPH, 9 no PH. SDCT examinations were analyzed by two blinded readers deciding on the diagnosis of CTEPH and scoring the extent of perfusion abnormalities on iodine density images. An additional reading was performed using conventional CTPA images only. Results: With access to SDCT data, both readers reached a sensitivity of 100% for the diagnosis of CTEPH with a specificity of 95.1% and 87.8%. On analysis of conventional CTPA images alone, specificity and diagnostic confidence decreased for both readers (Specificity 90.2 and 85.3%) while sensitivity dropped for the less experienced reader only (Sensitivity 78.9%). Patients with PH showed significantly more perfusion abnormalities than patients without PH (16.6 +/- 8.4 vs. 9.5 +/- 8.9 p < 0.001) and the extent of perfusion abnormalities correlated with the mean pulmonary artery pressure (r = 0.37 p = 0.008). Conclusions: SDCT offers confident identification of patients with CTEPH and enables a comprehensive analysis of pulmonary vasculature, pulmonary perfusion and the lung parenchyma in a single examination for patients with suspected PH. (C) 2019 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kroeger, Jan Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhardt, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-137771
DOI:	10.1016/j.ijcard.2019.03.018
Journal or Publication Title:	Int. J. Cardiol.
Volume:	285
Page Range:	S. 80 - 86
Date:	2019
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1874-1754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; PERFUSED BLOOD-VOLUME; MONOENERGETIC IMAGES; COMPUTED-TOMOGRAPHY; ANGIOGRAPHY; SCINTIGRAPHY; DISEASE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13777