Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1187
Title: Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.
Epworth Authors: Compton, Gregory
Other Authors: Caro-Domínguez, Pablo
Humpl, Tilman
Manson, David
Keywords: Aorta
Diagnostic Imaging
Cardiac Catheterization
Hypertension, Pulmonary
Predictive Value of Tests
Pulmonary Artery
Tomography, X-Ray Computed
Methods
Pulmonary Arterial Hypertension
Children
Paediatric
Dignosis
Main Pulmonary Artery
Ascending Aorta Diameter
MPA
Assessment Tool
Multi-Detector CT Imaging
Computed Tomography
Multi-Detector Computed Tomography Imaging
CT
Ratio
Epworth Medical Imaging, Victoria, Australia
Issue Date: Sep-2016
Publisher: Springer
Citation: Pediatr Radiol. 2016 Sep;46(10):1378-83
Abstract: BACKGROUND: The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. OBJECTIVE: To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. MATERIALS AND METHODS: We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. RESULTS: Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. CONCLUSION: The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children.
URI: http://hdl.handle.net/11434/1187
DOI: 10.1007/s00247-016-3636-5
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/27194438
ISSN: 0301-0449
1432-1998
Journal Title: Pediatric Radiology
Type: Journal Article
Affiliated Organisations: Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, Canada
Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Cardiac Sciences

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