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Audit, research and guideline update
CT features of pulmonary arterial hypertension and its major subtypes: a systematic CT evaluation of 292 patients from the ASPIRE Registry
  1. S Rajaram1,
  2. A J Swift1,
  3. R Condliffe2,
  4. C Johns1,
  5. C A Elliot2,
  6. C Hill3,
  7. C Davies3,
  8. J Hurdman2,
  9. I Sabroe2,
  10. J M Wild1,
  11. D G Kiely2
  1. 1Academic Unit of Radiology, University of Sheffield, Sheffield, UK
  2. 2Sheffield Pulmonary Vascular Disease Unit and Academic Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
  3. 3Department of Radiology, Sheffield Teaching Hospitals, UK
  1. Correspondence to Dr Smitha Rajaram, Academic Unit of Radiology, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK; docmeethu{at}yahoo.com

Abstract

We evaluated the prevalence and prognostic value of CT-pulmonary angiographic (CTPA) measures in 292 treatment naive patients with pulmonary arterial hypertension (PAH). Pulmonary artery calcification (13%) and thrombus (10%) were exclusively seen in PAH-congenital heart disease. Oesophageal dilation (46%) was most frequent in PAH-systemic sclerosis. Ground glass opacification (GGO) (41%), pericardial effusion (38%), lymphadenopathy (19%) and pleural effusion (11%) were common. On multivariate analysis, inferior vena caval area, the presence of pleural effusion and septal lines predicted outcome. In PAH, CTPA provides diagnostic and prognostic information. In addition, the presence of GGO on a CT performed for unexplained breathlessness should alert the physician to the possibility of PAH.

  • Primary Pulmonary Hypertension

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