DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20192064

Main pulmonary artery diameter assessment in a large sample of Indian population: a MDCT based study

Abdul Haseeb Wani, Yassar Shiekh, Najeeb Tallal Ahangar

Abstract


Background: The gold standard for pulmonary artery pressure measurement is right heart catheterization but its invasive nature precludes its routine use. Main pulmonary arterial trunk calibre increase is a strong indicator of underlying pulmonary arterial hypertension. MDCT can accurately measure the diameter of main pulmonary artery. The objective of the study was to establish the normative values of main pulmonary artery caliber using contrast enhanced CT and try to ascertain any significant difference in main pulmonary artery calibers between two genders and correlation of age and main pulmonary artery diameter.

Methods: Contrast enhanced CT images of 462 subjects were analysed on a PACS workstation monitor and widest diameter perpendicular to long axis of the main pulmonary artery as seen on reformatted axial image was measured with electronic caliper tool at the level of the main pulmonary artery bifurcation.  

Results: The mean main pulmonary artery diameter in females was 22.54±2.19 mm and 23.34±3.06 mm in males. The mean pulmonary artery diameter in males was larger than females with statistically significant difference seen (p<0.05). The correlation coefficient between age of whole sample and their mean main pulmonary artery was found to be 0.1006 with no statistically significant difference.

Conclusions: There is a statistically significant difference in the mean main pulmonary artery calibre between males and females with no strong correlation between the age and mean main pulmonary artery calibre. Further studies are warranted to find the complex interaction between main pulmonary artery diameter and sex, age and body mass index.


Keywords


Main pulmonary artery, Main pulmonary artery diameter, Contrast-enhanced CT thorax, Electronic caliper tool, Reformatted axial image, Correlation coefficient

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References


van Erkel AR, van Rossum AB, Bloem JL,Kievit J, Pattynama PM. Spiral CT angiography for suspected pulmonary embolism:cost-effectiveness analysis. Radiology. 1996;201:29–36.

Stein PD, Athanasoulis C, Alavi A, Greenspan RH, Hales CA, Saltzman HA, et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation. 1992;85:462–8.

Altman DG, Bland JM. Measurement in medicine:the analysis of method comparison studies. J Royal Statistical Society: Series D (The Statistician). 1983;32(3):307-17.

Kanemoto N, Furuya H, Etoh T, SasamotoH, Matsuyama S. Chest roentgenograms in primary pulmonary hypertension. Chest 1979;76:45–49.

Matthay RA, Schwarz MI, Ellis JH Jr, Steele PP, Siebert PE, Durrance JR, et al. Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography. Invest Radiol. 1981;16:95–100.

Schmidt HC, Kauczor HU, Schild HH, Renner C, Kirchhoff E, Lang P, et al. Pulmonary hypertension in patients with chronic pulmonary tromboembolism: chest radiograph and CT evaluation before and after surgery. Eur Radiol. 1996;6:817– 25.

Haimovici JB, Trotman-Dickenson B, Halpern EF, Dec GW, Ginns LC, Shepard JA, et al. Relationship between pulmonary artery diameter at computed tomography and pulmonary artery pressures at right-sided heart catheterization. Massachusetts General Hospital Lung Transplantation Program. Acad Radiol. 1997;4:327–34.

Edwards PD, Bull RK, Coulden R. CT measurement of main pulmonary artery diamater. Br J Radiol. 1998;71:1018–20.

Kuriyama K, Gamsu G, Stern RG, Cann CE, Herfkens RJ, Brundage BH. CT-determined pulmonary artery diameters in predicting pulmonary hypertension. Invest Radiol. 1984;19:16–22.

Tan RT, Kuzo R, Goodman LR, et al.Utility of CT scan evaluation predicting pulmonary hypertension in patients with parenchymal lung disease. Chest. 1998;113:1250–6.

Ng CS, Wells AU, Padley SP. A CT sign of chronic pulmonary arterial hypertension:the ratio of main pulmonary artery to aortic diameter. J Thorac Imaging. 1999;14:270–8.

Heinrich M, Uder M, Tscholl D, Grgic A,Kramann B, Schafers HJ. CT scan findings in chronic thromboembolic pulmonary hypertension:predictors of hemodynamic improvement after pulmonary thromboendarterectomy. Chest. 2005;127:1606– 13.

Guthaner DF, Wexler L, Harell C. CT demonstration of cardiac structures. AJR Am J Roentgenol. 1979;133:75–81.

Kuriyama K, Gamsu G, Stern RG, Cann CE, Herfkens RJ, Brundage BH. CT-determined pulmonary artery diameters in predicting pulmonary hypertension. Invest Radiol. 1984;19:16 –22.

Haimovici JB, Trotman-Dickenson B, Halpern EF, Dec GW, Ginns LC, Shepard JA, et al. Relationship between pulmonary artery diameter at computed tomography and pulmonary artery pressures at right-sided heart catheterization. Massachusetts General Hospital Lung Transplantation Program. Acad Radiol. 1997;4:327–34.

Moore NR, Scott JP, Flower CD, Higenbottam TW. The relationship between pulmonary artery pressure and pulmonary artery diameter in pulmonary hypertension. Clin Radiol. 1988;39:486– 9.

Wittram C. The normal main pulmonary artery diameter. Br J Radiol. 2003;76:79.

Kruger S, Haage P, Hoffmann R, Breuer C, Bucker A, Hanrath P, et al. Diagnosis of pulmonary arterial hypertension and pulmonaryembolism with magnetic resonance angiography. Chest. 2001;120:1556–61.

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, PellikkaPA, et al. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7:79–108.