Table 3.
Sensitivity and specificity of different pulmonary artery diameter cut-offs for identifying pulmonary hypertension
| Study | PH [Patients/ Total (%)] | WHO Group of PH | Mode of PH Diagnosis | Size of PA* (mm) | Imaging (Contrast) | Vessel Parameter Measured† | SN (%) | SP (%) | Comments |
|---|---|---|---|---|---|---|---|---|---|
| Kuriyama et al. (4) | 11/27 (41) | Mixed | RHC | 28.6 | CT (V) | External (density profile) | 69 | 100 | Vessels measured using a CT density profile of the artery and adjacent tissues |
| A mean PA pressure > 18 mm Hg was considered PH | |||||||||
| Tan et al. (7) | 36/45 (80) | 3 | RHC | 29.0 | CT (V) | NA | 87 | 89 | PPV very high because studied population included mostly those with PH (four times as many patients as control subjects) |
| A PA diameter of 29.0 mm + ABR > 1.1 had a specificity of 100% | |||||||||
| Edwards et al. (24) | 12/112 (11) | 1 | RHC | 33.2 | CT (N) | External | 58 | 95 | Unenhanced CT (external diameter of vessel measured) |
| Ng et al. (27) | 37/50 (74) | Mixed | RHC | 30.0 | CT (V) | Variable | 68 | 100 | PH was considered as a mean PA pressure ≥ 20 mm Hg |
| Pérez-Enguix et al. (8) | 34/59 (58) | 3 | RHC | 29 | CT (V) | NA | 65 | 61 | Clinical diagnoses were predominantly emphysema, pulmonary fibrosis, and cystic fibrosis |
| Alhamad et al. (63) | 37/63 | 3 | RHC | 25 | CT (V) | External | 86 | 41.2 | Mixed cohort did not include patients with interstitial lung disease |
| 15/19 | Mixed | RHC | 31.6 | CT (V) | External | 47 | 93 | ||
| Lange et al. (5) | 26/78 (33) | Mixed | RHC | 29.0 | CT (V) | NA | 77 | 62 | Included patients with mean PA pressure of 21–24 mm Hg |
| Mahammedi et al. (9) | 298/102 (75) | Mixed | RHC | 29.5 | CT (V) | Variable | 71 | 79 | A main PA over aortic diameter > 1 has a sensitivity and specificity for detecting PH of 71 and 77%, respectively |
| McCall et al. (6) | 32/48 (66.7) | 1, 3 | RHC | 30.8 | CT (NA) | NA | 81.3 | 87.5 | Included patients with scleroderma and several with unidentified connective tissue disease |
| Burger et al. (26) | 37/100 (37) | Mixed | ECHO | 30.0 | CT (N) | External | 78 | 91 | Unenhanced CT |
| Sanal et al. (89) | 51/190 (27) | 4 | ECHO | 28.6 | CT (Y) | NA | 75 | 75 | Only studied patients with acute pulmonary embolism |
| Estimate RVSP for considering PH was 50 mm Hg |
Definition of abbreviations: ABR = artery to bronchus ratio; CT = computed tomography; ECHO = echocardiography; N = no; NA = not available; PA = pulmonary artery; PH = pulmonary hypertension; PPV = positive predictive value; RHC = right heart catheterization; RVSP = right ventricular systolic pressure; SN = sensitivity; SP = specificity; WHO = World Health Organization; V = variable (some patients received contrast while others did not); Y = yes.
*
Cut-off value selected by the investigators, above which predicted the presence of PH.
†
Internal (lumen) or external (entire vessel) diameter.