Document Detail

The right sided great vessels by cardiac multidetector computed tomography: normative reference values among healthy adults free of cardiopulmonary disease, hypertension, and obesity.
MedLine Citation:
PMID:  19394871     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVES: We sought to derive normative reference values for the thoracic great vessels using multidetector computed tomography (MDCT) in a healthy normotensive non-obese population free of cardiovascular disease. MATERIALS AND METHODS: Non-gated axial computed tomography (CT) of the chest has traditionally been used to evaluate normal great vessel anatomy for prognosis and management. However, non-gated axial chest CT cannot account for the obliquity, systolic expansion, and non-axial motion of the great vessels during the cardiac cycle and may misclassify patients as normal or abnormal for prognostic and management purposes. To date, normative reference values for double-oblique, short-axis great vessel diameters have not been established using current generation electrocardiogram (ECG)-gated 64-detector row MDCT. A total of 103 (43% women, age 51 +/- 14 years) consecutive normotensive, non-obese adults free of cardiopulmonary or great vessel structural disease, arrhythmias, or significant coronary artery disease were studied by MDCT. Individuals underwent examination for determination of end-diastolic (ED) pulmonary artery (PA) and superior vena cava (SVC) dimensions in double-oblique short axes for comparison with the ascending aorta and the right-sided cardiac chambers. RESULTS: For right sided great vessels, the 5th to 95th interval was 1.89-3.03 cm for ED PA diameter and 1.08-4.42 cm(2) for SVC cross-sectional area. The pulmonary artery to ascending aortic (PA-to-Ao) ratio was 0.66-1.13. In multivariate analysis, the PA was significantly associated with weight, whereas the PA-to-Ao ratio was inversely associated with age. Axial PA measurements were significantly higher and PA-to-Ao measurements significantly lower than corresponding short axis measurements (P = .04 and P < .001, respectively). CONCLUSIONS: This study establishes ECG-gated MDCT reference values for right-sided great vessel dimensions derived from a healthy population of individuals free of cardiovascular disease, hypertension, and obesity. The traditional axial PA-to-Ao discriminant value of 1 for pulmonary hypertension is a poor diagnostic tool because it encompasses normal patients and is negatively affected by age. Thoracic great vessels should be measured by CT in ECG-gated double-oblique short-axis for accurate quantitation. These data may serve as a reference to identify right-sided great vessel pathology in individuals being referred for ECG-gated MDCT imaging.
Fay Y Lin; Richard B Devereux; Mary J Roman; Joyce Meng; Veronica M Jow; Lauren Simprini; Avrum Jacobs; Jonathan W Weinsaft; Leslee J Shaw; Daniel S Berman; Tracy Q Callister; James K Min
Publication Detail:
Type:  Journal Article     Date:  2009-04-25
Journal Detail:
Title:  Academic radiology     Volume:  16     ISSN:  1878-4046     ISO Abbreviation:  Acad Radiol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-07     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  981-7     Citation Subset:  IM    
Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, 520 E 70th Street, New York, NY 10021, USA.
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MeSH Terms
Angiography / methods*
Body Size
Cardiovascular Diseases / radiography
Hypertension / radiography
Lung Diseases / radiography
Middle Aged
New York
Obesity / radiography
Phlebography / methods*
Pulmonary Artery / radiography*
Radiography, Thoracic / methods,  standards,  statistics & numerical data
Reference Values
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*,  standards,  statistics & numerical data*
Vena Cava, Superior / radiography*

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