Hepatopulmonary syndrome has low prevalence of pulmonary vascular abnormalities on chest computed tomography


Autoři: Luciano Folador aff001;  Felipe S. Torres aff003;  Juliana F. Zampieri aff002;  Betina C. Machado aff001;  Marli M. Knorst aff001;  Marcelo B. Gazzana aff001
Působiště autorů: Programa de Pós-Graduação em Ciências Pneumológicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil aff001;  Serviço de Radiologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil aff002;  Department of Medical Imaging, University of Toronto, Toronto, ON, Canada aff003;  Serviço de Pneumologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223805

Souhrn

Purpose

Hepatopulmonary syndrome (HPS) is defined as an arterial oxygenation defect induced by intrapulmonary vascular dilatations associated with hepatic disease. This study aimed to assess the prevalence of type 1 and 2 pulmonary vascular abnormalities on chest computed tomography (CT) in patients with cirrhosis and HPS and to characterize intra- and interobserver reliability.

Materials and methods

Two thoracic radiologists retrospectively evaluated chest CT scans from 38 cirrhosis patients with HPS. They classified the pulmonary vascular abnormalities as type 1 (multiple dilated distal pulmonary arteries), type 2(nodular dilatation or individual pulmonary arterial malformation), or absence of abnormality. Furthermore, they measured the diameters of the central pulmonary arteries and subsegmental pulmonary arteries and bronchi. We analyzed the prevalence, intraobserver reliability, and interobserver reliability of abnormal CT findings related to HPS, and the correlation of these findings with partial arterial oxygen pressure (PaO2).

Results

The overall prevalence of pulmonary vascular abnormalities was 28.9% (95% confidence intervals: 15.4%, 45.9%). Moreover, 26.3% of patients had type 1 abnormality (13.4%, 43.1%) and 2.6% of patients had type 2 abnormality (0.0%, 13.8%). The intraobserver reliability kappa value was 0.666 (0.40, 0.91) and the interobserver kappa value was 0.443 (0.12, 0.77). There was no correlation between pulmonary vascular abnormalities on CT and PaO2 values.

Conclusions

The prevalence of pulmonary vascular abnormalities on chest CT of patients with cirrhosis and HPS is low and not correlated with PaO2. These findings question the usefulness of chest CT for the evaluation of patients with cirrhosis and HPS.

Klíčová slova:

Arteries – Blood – Cirrhosis – Computed axial tomography – Oxygen – Pulmonary arteries – Hantavirus pulmonary syndrome – Bronchi


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Článek vyšel v časopise

PLOS One


2019 Číslo 10