TY - JOUR
T1 - Right ventricular extracellular volume with dual-layer spectral detector CT
T2 - Value in chronic thromboembolic pulmonary hypertension
AU - Yamasaki, Yuzo
AU - Abe, Kohtaro
AU - Kamitani, Takeshi
AU - Sagiyama, Koji
AU - Hida, Tomoyuki
AU - Hosokawa, Kazuya
AU - Matsuura, Yuko
AU - Hioki, Kazuhito
AU - Nagao, Michinobu
AU - Yabuuchi, Hidetake
AU - Ishigami, Kousei
N1 - Funding Information:
Supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (grant 20K16728) and the research grant of the Japanese Radiological Society from Bayer (KJ-2019-2).
Publisher Copyright:
© RSNA, 2021
PY - 2021/3
Y1 - 2021/3
N2 - Background: Right ventricular (RV) extracellular volumes (ECVs), as a surrogate for histologic fibrosis, have not been sufficiently investigated. Purpose: To evaluate and compare RV and left ventricular (LV) ECVs obtained with dual-layer spectral detector CT (DLCT) in chronic thromboembolic pulmonary hypertension (CTEPH) and investigate the clinical importance of RV ECV. Materials and Methods: Retrospective analysis was performed on data from 31 patients with CTEPH (17 were not treated with pulmonary endarterectomy [PEA] or balloon pulmonary angioplasty [BPA] and 14 were) and eight control subjects who underwent myocardial delayed enhancement (MDE) DLCT from January 2019 to June 2020. The ECVs in the RV and LV walls were calculated by using iodine density as derived from spectral data pertaining to MDE. Statistical analyses were performed with one-way repeated analysis of variance with the Tukey post hoc test or the Kruskal-Wallis test with the Steel-Dwass test and linear regression analysis. Results: The PEA- and BPA-naive group showed significantly higher ECVs than the PEA- or BPA-treated group and control group in the septum (28.2% 6 2.9 vs 24.3% 6 3.6, P =.005), anterior right ventricular insertion point (RVIP) (32.9% 6 4.6 vs 25.3% 6 3.6, P,.001), posterior RVIP (35.2% 6 5.2 vs 27.3% 6 4.2, P,.001), mean RVIP (34.0% 6 4.2 vs 26.3% 6 3.4, P,.001), RV free wall (29.5% 6 3.3 vs 25.9% 6 4.1, P =.036), and mean RV wall (29.1% 6 3.0 vs 26.1% 6 3.1, P =.029). There were no significant differences between the PEA- or BPA-treated group and control subjects in these segments (septum, P =.93; anterior RVIP, P =.38; posterior RVIP, P =.52; mean RVIP, P =.36; RV free wall, P =.97; and mean RV, P =.33). There were significant correlations between ECV and mean pulmonary artery pressure (PAP) or brain natriuretic peptide (BNP) in the mean RVIP (mean PAP: R = 0.66, P,.001; BNP: R = 0.44, P =.014) and the mean RV (mean PAP: R = 0.49, P =.005; BNP: R = 0.44, P =.013). Conclusion: Right ventricular and right ventricular insertion point extracellular volumes could be noninvasive surrogate markers of disease severity and reverse tissue remodeling in chronic thromboembolic pulmonary hypertension.
AB - Background: Right ventricular (RV) extracellular volumes (ECVs), as a surrogate for histologic fibrosis, have not been sufficiently investigated. Purpose: To evaluate and compare RV and left ventricular (LV) ECVs obtained with dual-layer spectral detector CT (DLCT) in chronic thromboembolic pulmonary hypertension (CTEPH) and investigate the clinical importance of RV ECV. Materials and Methods: Retrospective analysis was performed on data from 31 patients with CTEPH (17 were not treated with pulmonary endarterectomy [PEA] or balloon pulmonary angioplasty [BPA] and 14 were) and eight control subjects who underwent myocardial delayed enhancement (MDE) DLCT from January 2019 to June 2020. The ECVs in the RV and LV walls were calculated by using iodine density as derived from spectral data pertaining to MDE. Statistical analyses were performed with one-way repeated analysis of variance with the Tukey post hoc test or the Kruskal-Wallis test with the Steel-Dwass test and linear regression analysis. Results: The PEA- and BPA-naive group showed significantly higher ECVs than the PEA- or BPA-treated group and control group in the septum (28.2% 6 2.9 vs 24.3% 6 3.6, P =.005), anterior right ventricular insertion point (RVIP) (32.9% 6 4.6 vs 25.3% 6 3.6, P,.001), posterior RVIP (35.2% 6 5.2 vs 27.3% 6 4.2, P,.001), mean RVIP (34.0% 6 4.2 vs 26.3% 6 3.4, P,.001), RV free wall (29.5% 6 3.3 vs 25.9% 6 4.1, P =.036), and mean RV wall (29.1% 6 3.0 vs 26.1% 6 3.1, P =.029). There were no significant differences between the PEA- or BPA-treated group and control subjects in these segments (septum, P =.93; anterior RVIP, P =.38; posterior RVIP, P =.52; mean RVIP, P =.36; RV free wall, P =.97; and mean RV, P =.33). There were significant correlations between ECV and mean pulmonary artery pressure (PAP) or brain natriuretic peptide (BNP) in the mean RVIP (mean PAP: R = 0.66, P,.001; BNP: R = 0.44, P =.014) and the mean RV (mean PAP: R = 0.49, P =.005; BNP: R = 0.44, P =.013). Conclusion: Right ventricular and right ventricular insertion point extracellular volumes could be noninvasive surrogate markers of disease severity and reverse tissue remodeling in chronic thromboembolic pulmonary hypertension.
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U2 - 10.1148/radiol.2020203719
DO - 10.1148/radiol.2020203719
M3 - Article
C2 - 33497315
AN - SCOPUS:85101935314
SN - 0033-8419
VL - 298
SP - 589
EP - 596
JO - Radiology
JF - Radiology
IS - 3
ER -