Measurement of lung density in congestive heart failure by computed tomography.

Abstract

SUMMARYThe computed tomography (CT) number within the region of interest (ROI) was used as a parameter to assess lung density in patients with congestive heart failure. Thirty-eight patients with valvular heart disease (VHD) and 34 patients with ischemic heart disease (IHD) were studied. Based on the New York Heart Association (NYHA) classification, 24 VHD patients were in class I or II (VHD I-II) and the other 14 were in NYHA class III or IV (VHD III-IV).Eighteen patients with IHD were in NYHA class I or II (IHD I-II) and 16 were in class III or IV (IHD III-IV). The CT number was measured bilaterally at the upper, middle and lower levels of the chest and compared with the corresponding values in 21 normal subjects (Group N). In a preliminary study on Group N, the CT numbers were insensitive to the size of the ROI, but were closely related to its location.In clinical applications, the mean values of the CT numbers in all six lung fields increased in the order of IHD I-II, to VHD I-II, IHD III-IV and VHD III-IV.Except for patients in IHD I-II, they were significantly larger than in Group N. The relationship between the CT number and the systolic and mean pulmonary arterial pressures and the pulmonary capillary wedge pressure were evaluated in 36 patients. Significant correlations were obtained in all six lung fields (r=0.65-0.78, p<0.001). The results suggest that measurement of lung density by CT is useful for the quantitative evaluation of the severity of disease in patients with congestive heart failure.

Diagnostic Value of Quantitative Lung Computed Tomography to Detect Clinical Heart Failure in Patients with Non-St-Elevation Myocardial Infarction

“…Comparison of the qualitative and quantitative CT approach to pulmonary congestion has not previously been explored. The reproducibility of both quantitative and qualitative methods was each in accordance with previous studies [22,27]. The quantitative methods were both more reproducible and better to discriminate between the heart failure and control groups than the qualitative approach.…”

Prognostic Value of the Average Lung CT Number in Patients with Acute Paraquat Poisoning

“…Te imaging data were analyzed using the Neusoftpicture archiving and communication system (PACS) (VE 5.5). Te three standard levels of chest HRCT were defned as follows: carinal plane, 5 cm plane above the carina, and 5 cm plane below the carina (Figure 2) [24][25][26]. Te average CT numbers of the three levels represent the mean lung density of the upper-, middle-, and lower-lung felds, respectively.…”

Computed Tomography Assessment of Lung Structure and Function in Pulmonary Edema

“…19 This was confirmed by Nomura et al who showed that in patients with congestive heart failure resulting from valvular and ischemic disease, lung density correlated with systolic, mean, and wedge pulmonary artery pressures. 20 This indicated that lung density could be used for quantitatively evaluating the severity of congestive heart failure. Kato et al who compared patients with congestive heart failure and normal subjects, 21 showed that the ratio between pixels ranging respectively from −650 to −750 HU and from −300 to 950 HU correlated with the wedge pulmonary artery pressure.…”