HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2223010668v1 222/3/782    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Resten, A. Articles by Musset, D. Search for Related Content PubMed PubMed Citation Articles by Resten, A. Articles by Musset, D.

Pulmonary Arterial Hypertension: Thin-Section CT Predictors of Epoprostenol Therapy Failure¹

¹ From the Departments of Radiology (A.R., S.M., D.M.), Pneumology and Respiratory Intensive Care (M.H., O.S., G.S.) and Pathologic Anatomy (F.C.), Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92140 Clamart, France. From the 2000 RSNA scientific assembly. Received March 26, 2001; revision requested April 30; revision received July 19; accepted October 22. Address correspondence to A.R. (e-mail: arnaud.resten@abc.ap-hop-paris.fr).

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.

© RSNA, 2002

Index terms: Hypertension, pulmonary, 56.78 • Lung, CT, 68.12118 • Lung, vascular disease, 56.788

This article has been cited by other articles:

				National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Heart, March 1, 2008; 94(Suppl_1): i1 - i41. [Full Text] [PDF]

				National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Thorax, March 1, 2008; 63(Suppl_2): ii1 - ii41. [Full Text] [PDF]

				A. A. Frazier, T. J. Franks, T.-L. H. Mohammed, I. H. Ozbudak, and J. R. Galvin From the Archives of the AFIP: Pulmonary Veno-occlusive Disease and Pulmonary Capillary Hemangiomatosis RadioGraphics, May 1, 2007; 27(3): 867 - 882. [Abstract] [Full Text] [PDF]

				L. Taraseviciene-Stewart, R. Scerbavicius, K.-H. Choe, C. Cool, K. Wood, R. M. Tuder, N. Burns, M. Kasper, and N. F. Voelkel Simvastatin causes endothelial cell apoptosis and attenuates severe pulmonary hypertension Am J Physiol Lung Cell Mol Physiol, October 1, 2006; 291(4): L668 - L676. [Abstract] [Full Text] [PDF]

				A. Rabiller, X. Jais, A. Hamid, A. Resten, F. Parent, R. Haque, F. Capron, O. Sitbon, G. Simonneau, and M. Humbert Occult alveolar haemorrhage in pulmonary veno-occlusive disease Eur. Respir. J., January 1, 2006; 27(1): 108 - 113. [Abstract] [Full Text] [PDF]

				A. Resten, S. Maitre, M. Humbert, A. Rabiller, O. Sitbon, F. Capron, G. Simonneau, and D. Musset Pulmonary Hypertension: CT of the Chest in Pulmonary Venoocclusive Disease Am. J. Roentgenol., July 1, 2004; 183(1): 65 - 70. [Abstract] [Full Text] [PDF]

				G. Simonneau, N. Galie, L. J. Rubin, D. Langleben, W. Seeger, G. Domenighetti, S. Gibbs, D. Lebrec, R. Speich, M. Beghetti, et al. Clinical classification of pulmonary hypertension J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 5S - 12S. [Abstract] [Full Text] [PDF]

				G. G. Pietra, F. Capron, S. Stewart, O. Leone, M. Humbert, I. M. Robbins, L. M. Reid, and R. M. Tuder Pathologic assessment of vasculopathies in pulmonary hypertension J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 25S - 32S. [Abstract] [Full Text] [PDF]

				J. R. Runo, C. L. Vnencak-Jones, M. Prince, J. E. Loyd, L. Wheeler, I. M. Robbins, K. B. Lane, J. H. Newman, J. Johnson, W. C. Nichols, et al. Pulmonary Veno-occlusive Disease Caused by an Inherited Mutation in Bone Morphogenetic Protein Receptor II Am. J. Respir. Crit. Care Med., March 15, 2003; 167(6): 889 - 894. [Abstract] [Full Text] [PDF]