The application value of vascular survey parameters of DSA imaging for predicting pulmonary hypertension in patients with pulmonary embolism

Abstract

Objective To investigate the application value of vascular surveying parameters of DSA imaging for predicting pulmonary hypertension in patients with pulmonary embolism. Methods The clinical data of 44 patients with DSA pulmonary angiography in the Affiliated Hospital of Xuzhou Medical College from June 2013 to June 2014 were retrospectively analyzed. The research group included 24 patients (PASP >30 mmHg) with pulmonary embolism confirmed by DSA; the control group included 20 cases of patients (PASP<25 mmHg) with no pulmonary embolism. Vascular parameters were measured in DSA images including main pulmonary artery diameter (MPAD), ascending aorta diameter (AAD), left pulmonary artery diameter(LPAD), right pulmonary artery diameter(RPAD) and right lower pulmonary artery diameter(RLPAD); and the ratio of MPAD and AAD (rPA) was calculated. The differences of the vascular parameters between two groups were analyzed by t test. The vascular parameters which have statistically significant were analyzed by ROC curve in order to assess and predict the specificity and sensitivity of pulmonary hypertension. Results MPAD, LPAD, RPAD, RLPAD and the rPA between the control group[(27.19±2.59)mm, (19.84±1.73)mm, (21.82±1.97)mm, (11.77±1.19)mm、0.83±0.07]and research group[(32.99±3.96)mm, (22.49±2.83)mm, (25.18±3.87)mm, (13.12±1.78)mm, 0.97±0.08] were statistically significant(all P values<0.01). The MPAD and rPA in the area under the ROC curve were 0.890, 0.929 (all P values<0.01), individually. The diagnostic value of rPA is the highest in all vascular parameters. Conclusions As the gold standard in the diagnosis of pulmonary embolism, DSA can predict pulmonary hypertension through the MPAD and rPA index and may be helpful in the clinical condition assessment and treatment choice. Key words: Pulmonary embolism; Angiography, digital subtraction; Hypertension, pulmonary; ROC curve