Application of CTPA imaging combined parameters to evaluate the degree of pulmonary hypertension

LUO Zhen; DAI Guochen; FAN Shali; YANG Yi; LIU Jingzhe

doi:10.20258/j.cnki.1006-9011.2025.02.010

Abstract：Objective This study aims to explore the correlation between computed tomography pulmonary angiography(CTPA)imaging parameters and pulmonary artery pressure and to establish a joint prediction model for PH degree.Methods Clinical and imaging data of 84 patients who underwent a CTPA contrast agent bolus injection test in our hospital's radiology department were retrospectively screened and analyzed.The pulmonary artery systolic pressure(PASP)was mea-sured by ultrasound and the correlation between CTPA imaging parameters and PH degree was observed.The patients were di-vided into no-mild PH group and moderate-severe PH group.Multivariate logistic regression analysis was constructed,and meaningful variables were selected to establish a nomogram,and the consistency curve and decision curve analysis were used to verify.Results Top time(TT),start time(ST),main pulmonary artery diameter(MPAD),and right ventricle maximum transverse diameter(RVMTD)were positively correlated with PASP[correlation coefficients(r)=0.285,0.294,0.426,0.354,P<0.01].On the other hand,there was no correlation between left ventricle maximum transverse diameter(LVMTD),RVMTD/LVMTD,and PASP(r=0.122,0.104,P>0.05).A positive correlation was found between TT,ST,MPAD,RVMTD,LVMTD and PH degree(r=0.265,0.282,0.539,0.361,0.233,P<0.05),but there was no correlation between RVMTD/LVMTD and PH degree(r=0.053,P>0.05).Age,MPAD,RVMTD,LVMTD and TT were all risk factors for moderate-severe PH.A predictive model was established to distinguish no-mild PH from moderate-severe PH.The area under the ROC curve of the model was 0.760(95%CI:0.640-0.880).The sensitivity and specificity of the threshold were 75.0%and 71.9%,respectively.Conclusion The selected CTPA scanning and imaging parameters are correlated with PH.In addition to comprehensively and accurately evaluating PH degree,the combined scanning and imaging parameters have a high predic-tive value.