CТ densitometry as an additional method in the diagnosis of pulmonary hypertension: a prospective study

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INTRODUCTION: This article presents the results of application of CT densitometry in the computed tomography (CT) of the chest to diagnose various forms of pulmonary hypertension.OBJECTIVES: To determine the diagnostic value of CT densitometry using comparative analysis of lung tissue density in patients with various forms of pulmonary hypertension.MATERIALS AND METHODS: The study included 528 patients diagnosed with pulmonary hypertension by means of right heart catheterization (RHC) of the National Research Cardiac Surgery Center, Republic of Kazakhstan. All patients were divided into 4 groups according to the classification of pulmonary hypertension of the World Health Organization (ESC/ERS Guidelines) from 2015. The first group included 254 patients with pulmonary hypertension pulmonary hypertension due to left heart disease (PHLHD). The second group included 210 patients with pulmonary arterial hypertension (PAH). The third group included 49 patients with chronic thromboembolic pulmonary hypertension (CTEPH). The fourth group — 15 patients with pulmonary hypertension due to respiratory disease (PHDRD). The mean age of the patients was 52.15±16.75 years. Contrast-enhanced chest CT imaging performed with a 64-slice multislice computed tomography system (Somatom Definition AS, Siemens) with post-processing to assess the lung tissue densitometric parameters, analyse the diameters of the pulmonary trunk and its main branches. The CT examination was carried in accordance with an «Embolism» protocol with intravenous administration of a contrast agent according to indications. Statistics: analysis was conducted using the Statistica 10 software. To quantitatively compare the two groups nonparametric Mann-Whitney test and the Kruskal-Wallace test were applied. Mean value and standard deviation in the format of «M±S» were used for quantitative parameters. Correlation analysis was carried out using Spearman’s nonparametric rank correlation.RESULTS: In patients with severe pulmonary hypertension a tendency for fibrotic changes was most clearly observed in cases of pulmonary hypertension due to left heart disease (–809.92±26.52), and emphysematous changes in the pulmonary arterial hypertension group (–843.27±43.88).CONCLUSION: CT lung densitometry should be performed in all patients with suspected pulmonary hypertension as an additional method of examination.