The Value Of Multi-slice Spiral CT In Diagnosis Of Pulmonary Hypertension In Patients With COPD

Objective To investigate the clinical diagnosis value of pulmonary hypertension (PH) caused by chronic obstructive pulmonary disease(COPD) by multi-slice spiral computed tomography(MSCT).Materials and Methods60patients with COPD clinically proved were involved in this study and were all underwent MSCT and ultrasonic cardiogram(UCG) examination PH was diagnosed if main pulmonary artery diameter(MPA) was larger than29mm,or the ratio of main pulmonary artery and ascending aorta diameter(rPAA) was larger than1,or the ratio of main pulmonary artery and descending aorta diameter (rPDA) was larger than l,or right inferior pulmonary artery (RIPA) diameter was larger than15mm,or a segmental artery-to-bronchus diameter ratio was larger than1in three or four lobes in axial MSCT scan.At the same time,pulmonary parenchymal disease and changes of right heart can be observed.Using Kappa test,PH diagnosed or not by MSCT was compared to those results with UCG.Results There were strong correlation between PASP and both MPA (r=0.699,P<0.05) and rPAA(r=0.510,P<0.05). rPDA,RIPA or four segmental artery-to-bronchus diameter ratio were no significant correlations with PASP.With MPA or rPAA as the index to diagnosis of PH, and echocardiography in the diagnosis of PH detection rate of the two methods have good consistency (Kappa>0.7), there was no statistically significant difference (P>0.05).Conclusion In patients with chronic obstructive pulmonary disease, the main pulmonary artery diameter and the ratio of main pulmonary artery and ascending aorta diameter is a reliable indicators for diagnosis of pulmonary hypertension. MSCT can diagnose pulmonary hypertension definitely in patients with chronic obstructive pulmonary disease.At the same time,it can provide more information, such as lesions of lung parenchyma as well as changes of right heart.