Pulmonary arterial hypertension:: Thin-section CT predictors of epoprostenol therapy failure

被引:60
作者
Resten, A
Maître, S
Humbert, M
Sitbon, O
Capron, F
Simoneau, G
Musset, D
机构
[1] Hop Antoine Beclere, Dept Radiol, F-92140 Clamart, France
[2] Hop Antoine Beclere, Dept Pneumol & Resp Intens Care, F-92140 Clamart, France
[3] Hop Antoine Beclere, Dept Anat Pathol, F-92140 Clamart, France
关键词
hypertension; pulmonary; lung; CT; vascular disease;
D O I
10.1148/radiol.2223010668
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To correlate pretherapeutic thin-section computed tomographic (CT) findings in patients with pulmonary hypertension with the risk of fatality with treatment with epoprostenol. MATERIALS AND METHODS: Seventy-three consecutive patients with severe pulmonary hypertension treated with epoprostenol were retrospectively separated into two groups. The first group included 12 patients who had a fatal outcome with epoprostenol therapy. The second group (n = 61) was a reference group of patients with epoprostenol-induced clinical improvement. Pretherapeutic thin-section CT scans of each patient were reviewed. RESULTS: Poorly defined nodular opacities (P = .003), septal lines (P = .04), pleural effusion (P = .01), and adenopathy (P = .009) strongly correlated with a risk of clinical worsening with treatment. In six patients in group 1, postmortem examination of the lung revealed either pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis. CONCLUSION: On pretherapeutic thin-section CT scans, poorly defined nodular opacities, septal lines, pleural effusion, and adenopathy should raise suspicion for pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis and provoke possible further evaluation before epoprostenol therapy. (C) RSNA, 2002.
引用
收藏
页码:782 / 788
页数:7
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