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. 1988 Feb;43(2):127–131. doi: 10.1136/thx.43.2.127

Diagnosis of pulmonary hypertension from radiographic estimates of pulmonary arterial size.

A Bush 1, H Gray 1, D M Denison 1
PMCID: PMC1020754  PMID: 3353884

Abstract

The reported accuracy of radiographic measurements in predicting pulmonary hypertension is very variable. Measurements of right and left descending pulmonary artery diameter have been reported to provide a correct diagnosis in as many as 98% of patients. A study was carried out to determine the predictive value of measurements made from the chest radiographs of 50 normal subjects and of 27 patients undergoing right heart catheterisation for cardiac or pulmonary vascular disease, taking account of radiographic magnification. After such corrections a right descending pulmonary artery diameter over 16.7 mm or a left descending pulmonary artery diameter of over 16.9 mm distinguished 12 of 23 pulmonary hypertensive subjects, with no false positive results. The diameter was then arbitrarily squared (any differences between patients and control subjects being exaggerated) and the product was divided by either predicted or actual lung volume in an attempt to correct for body size. The new index distinguished 19 of 23 patients with pulmonary hypertension, with one false positive, when the divisor was actual lung volume; when predicted lung volume was used 18 of 23 patients were distinguished, again with one false positive result.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronberg D. J., Glazer H. S., Madsen K., Sagel S. S. Normal thoracic aortic diameters by computed tomography. J Comput Assist Tomogr. 1984 Apr;8(2):247–250. [PubMed] [Google Scholar]
  2. Black L. F., Offord K., Hyatt R. E. Variability in the maximal expiratory flow volume curve in asymptomatic smokers and in nonsmokers. Am Rev Respir Dis. 1974 Sep;110(3):282–292. doi: 10.1164/arrd.1974.110.3.282. [DOI] [PubMed] [Google Scholar]
  3. Bush A., Denison D. M. Use of different magnification factors to calculate radiological lung volumes. Thorax. 1986 Feb;41(2):158–159. doi: 10.1136/thx.41.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. CHANG C. H. The normal roentgenographic measurement of the right descending pulmonary artery in 1,085 cases. Am J Roentgenol Radium Ther Nucl Med. 1962 May;87:929–935. [PubMed] [Google Scholar]
  5. Castillo Y., Kruger H., Arias-Stella J., Hurtado A., Harris P., Heath D. Histology, extensibility, and chemical composition of pulmonary trunk in persons living at sea-level and at high altitude in Peru. Br Heart J. 1967 Jan;29(1):120–128. doi: 10.1136/hrt.29.1.120. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chen J. T., Behar V. S., Morris J. J., Jr, McIntosh H. D., Lester R. G. Correlation of roentgen findings with hemodynamic data in pure mitral stenosis. Am J Roentgenol Radium Ther Nucl Med. 1968 Feb;102(2):280–292. doi: 10.2214/ajr.102.2.280. [DOI] [PubMed] [Google Scholar]
  7. Chetty K. G., Brown S. E., Light R. W. Identification of pulmonary hypertension in chronic obstructive pulmonary disease from routine chest radiographs. Am Rev Respir Dis. 1982 Aug;126(2):338–341. doi: 10.1164/arrd.1982.126.2.338. [DOI] [PubMed] [Google Scholar]
  8. Dash H., Lipton M. J., Chatterjee K., Parmley W. W. Estimation of pulmonary artery wedge pressure from chest radiograph in patients with chronic congestive cardiomyopathy and ischaemic cardiomyopathy. Br Heart J. 1980 Sep;44(3):322–329. doi: 10.1136/hrt.44.3.322. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Forrester J. S., Diamond G. A., Swan H. J. Correlative classification of clinical and hemodynamic function after acute myocardial infarction. Am J Cardiol. 1977 Feb;39(2):137–145. doi: 10.1016/s0002-9149(77)80182-3. [DOI] [PubMed] [Google Scholar]
  10. GRAINGER R. G. II. Interstitial pulmonary oedema and its radiological diagnosis: a sign of pulmonary venous and capillary hypertension. Br J Radiol. 1958 Apr;31(364):201–217. doi: 10.1259/0007-1285-31-364-201. [DOI] [PubMed] [Google Scholar]
  11. Harris P., Heath D., Apostolopoulos A. Extensibility of the human pulmonary trunk. Br Heart J. 1965 Sep;27(5):651–659. doi: 10.1136/hrt.27.5.651. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Harris P., Heath D., Apostolopoulos A. Extensibility of the pulmonary trunk in heart disease. Br Heart J. 1965 Sep;27(5):660–666. doi: 10.1136/hrt.27.5.660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hopkins R. A., Hammon J. W., Jr, McHale P. A., Smith P. K., Anderson R. W. Pulmonary vascular impedance analysis of adaptation to chronically elevated blood flow in the awake dog. Circ Res. 1979 Aug;45(2):267–274. doi: 10.1161/01.res.45.2.267. [DOI] [PubMed] [Google Scholar]
  14. JOHNSON P. M., WOOD E. H., PASTERNACK B. S., JONES M. A. Roentgen evaluation of pulmonary arterial pressure in mitral stenosis. Radiology. 1961 Apr;76:541–547. doi: 10.1148/76.4.541. [DOI] [PubMed] [Google Scholar]
  15. Kuriyama K., Gamsu G., Stern R. G., Cann C. E., Herfkens R. J., Brundage B. H. CT-determined pulmonary artery diameters in predicting pulmonary hypertension. Invest Radiol. 1984 Jan-Feb;19(1):16–22. doi: 10.1097/00004424-198401000-00005. [DOI] [PubMed] [Google Scholar]
  16. LAVENDER J. P., DOPPMAN J., SHAWDON H., STEINER R. E. Pulmonary veins in left ventricular failure and mitral stenosis. Br J Radiol. 1962 May;35:293–302. doi: 10.1259/0007-1285-35-413-293. [DOI] [PubMed] [Google Scholar]
  17. Lupi E., Dumont C., Tejada V. M., Horwitz S., Galland F. A radiologic index of pulmonary arterial hypertension. Chest. 1975 Jul;68(1):28–31. doi: 10.1378/chest.68.1.28. [DOI] [PubMed] [Google Scholar]
  18. Matthay R. A., Schwarz M. I., Ellis J. H., Jr, Steele P. P., Siebert P. E., Durrance J. R., Levin D. C. Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography. Invest Radiol. 1981 Mar-Apr;16(2):95–100. doi: 10.1097/00004424-198103000-00003. [DOI] [PubMed] [Google Scholar]
  19. PATEL D. J., SCHILDER D. P., MALLOS A. J. Mechanical properties and dimensions of the major pulmonary arteries. J Appl Physiol. 1960 Jan;15:92–96. doi: 10.1152/jappl.1960.15.1.92. [DOI] [PubMed] [Google Scholar]
  20. Pierce R. J., Brown D. J., Holmes M., Cumming G., Denison D. M. Estimation of lung volumes from chest radiographs using shape information. Thorax. 1979 Dec;34(6):726–734. doi: 10.1136/thx.34.6.726. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Reuben S. R., Butler J., Lee G. J. Pulmonary arterial compliance in health and disease. Br Heart J. 1971 Jan;33(1):147–147. [PubMed] [Google Scholar]

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