Korean Journal of Radiology

  • 제20권6호
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  • Pages.976-984
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  • 2019
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Diagnosis of Pulmonary Arterial Hypertension in Children by Using Cardiac Computed Tomography

  • Shyh-Jye Chen (Department of Radiology and Medical Imaging, National Taiwan University Hospital, Medical College, National Taiwan University) ;
  • Jou-Hsuan Huang (Department of Radiology and Medical Imaging, National Taiwan University Hospital, Medical College, National Taiwan University) ;
  • Wen-Jeng Lee (Department of Radiology and Medical Imaging, National Taiwan University Hospital, Medical College, National Taiwan University) ;
  • Ming-Tai Lin (Department of Pediatrics, National Taiwan University Hospital, Medical College, National Taiwan University) ;
  • Yih-Sharng Chen (Department of Surgery, National Taiwan University Hospital, Medical College, National Taiwan University) ;
  • Jou-Kou Wang (Department of Pediatrics, National Taiwan University Hospital, Medical College, National Taiwan University)
  • 투고 : 2018.10.02
  • 심사 : 2019.02.02
  • 발행 : 2019.06.01
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초록

Objective: To establish diagnostic criteria for pulmonary arterial hypertension (PAH) in children by using parameters obtained through noninvasive cardiac computed tomography (CCT). Materials and Methods: We retrospectively measured parameters from CCT images of children from a single institution in a multiple stepwise process. A total of 208 children with mean age of 10.5 years (range: 4 days-18.9 years) were assessed. The variables were classified into three groups: the great arteries; the ventricular walls; and the bilateral ventricular cavities. The relationship between the parameters obtained from the CCT images and mean pulmonary arterial pressure (mPAP) was tested and adjusted by the children's body size. Reference curves for the pulmonary trunk diameter (PTD) and ratio of diameter of pulmonary trunk to ascending aorta (rPTAo) of children with CCT images of normal hearts, adjusted for height, were plotted. Threshold lines were established on the reference curves. Results: PTD and rPTAo on the CCT images were significantly positively correlated with mPAP (r > 0.85, p < 0.01). Height was the body size parameter most correlated with PTD (r = 0.91, p < 0.01) and rPTAo (r = -0.69, p < 0.01). On the basis of the threshold lines on the reference curves, PTD and rPTAo both showed 88.9% sensitivity for PAH diagnosis, with negative predictive values of 93.3% and 92.9%, respectively. Conclusion: PTD and rPTAo measured from CCT images were significantly correlated with mPAP in children. Reference curves and the formula of PTD and rPTAo adjusted for height could be practical for diagnosing PAH in children.

키워드

과제정보

This study was supported from our National Science Council by a project (NSC 98-2314-B-002-061).

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