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Changes in Cross-Sectional Area and Transverse Diameter of the Heart on Inspiratory and Expiratory Chest CT: Correlation with Changes in Lung Size and Influence on Cardiothoracic Ratio Measurement.

Tomita H, Yamashiro T, Matsuoka S, Matsushita S, Kurihara Y, Nakajima Y - PLoS ONE (2015)

Bottom Line: Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01).CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001).The CTR is also significantly influenced by ventilation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

ABSTRACT

Objective: The aim of this study was to investigate physiological changes in cardiac area and diameters between inspiratory and expiratory chest computed tomography (CT), and to assess their correlation with lung size change and influence on cardiothoracic ratio (CTR) measurements.

Materials and methods: The institutional review board of our institution approved this study, and informed consent was waived. Forty-three subjects underwent inspiratory and expiratory chest CT as part of routine clinical care. On both inspiratory and expiratory scans, lung volumes and maximum lung diameters (transverse and vertical directions) were measured. The maximum cardiac cross-sectional area (CSA) and the maximum transverse cardiac diameter were measured on both scans, and the CT-based CTR was calculated. Changes in the lung and cardiac measurements were expressed as the expiratory/inspiratory (E/I) ratios. Comparisons between inspiratory and expiratory measurements were made by the Wilcoxon signed-rank test. Correlations between the E/I ratios of lung and heart measurements were evaluated by Spearman's rank correlation analysis.

Results: Cardiac CSA and transverse cardiac diameter was significantly larger on expiratory than on inspiratory CT (p < 0.0001). Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01). CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001).

Conclusions: Heart size on chest CT depends on the phase of ventilation, and is correlated with changes in lung volume and craniocaudal lung diameter. The CTR is also significantly influenced by ventilation.

No MeSH data available.


Related in: MedlinePlus

17-year-old male with bronchiectasis.Axial and reconstructed coronal CT images at inspiration (A and C) and at expiration (B and D) are shown. The cardiac cross-sectional area and transverse cardiac diameters are smaller at inspiration (A) than at expiration (B). Based on reconstructed coronal images (C, inspiratory; D, expiratory), the diaphragm is dislocated downward during inspiration and the cardiac long axis leans vertically (C) compared with expiration (D). Note that reconstructed coronal images are shown as a reference and were not used for analysis in the study.
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pone.0131902.g002: 17-year-old male with bronchiectasis.Axial and reconstructed coronal CT images at inspiration (A and C) and at expiration (B and D) are shown. The cardiac cross-sectional area and transverse cardiac diameters are smaller at inspiration (A) than at expiration (B). Based on reconstructed coronal images (C, inspiratory; D, expiratory), the diaphragm is dislocated downward during inspiration and the cardiac long axis leans vertically (C) compared with expiration (D). Note that reconstructed coronal images are shown as a reference and were not used for analysis in the study.

Mentions: The maximum cardiac CSA based on CT was significantly smaller at inspiration (7.35 cm2 ± 1.57) than at expiration (8.24 cm2 ± 7.35) (p < 0.0001, Table 1). Also, the maximum transverse cardiac diameter was smaller at inspiration (11.6 cm ± 1.3) than at expiration (12.1 cm ± 1.4, p < 0.0001) (Fig 2).


Changes in Cross-Sectional Area and Transverse Diameter of the Heart on Inspiratory and Expiratory Chest CT: Correlation with Changes in Lung Size and Influence on Cardiothoracic Ratio Measurement.

Tomita H, Yamashiro T, Matsuoka S, Matsushita S, Kurihara Y, Nakajima Y - PLoS ONE (2015)

17-year-old male with bronchiectasis.Axial and reconstructed coronal CT images at inspiration (A and C) and at expiration (B and D) are shown. The cardiac cross-sectional area and transverse cardiac diameters are smaller at inspiration (A) than at expiration (B). Based on reconstructed coronal images (C, inspiratory; D, expiratory), the diaphragm is dislocated downward during inspiration and the cardiac long axis leans vertically (C) compared with expiration (D). Note that reconstructed coronal images are shown as a reference and were not used for analysis in the study.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4494711&req=5

pone.0131902.g002: 17-year-old male with bronchiectasis.Axial and reconstructed coronal CT images at inspiration (A and C) and at expiration (B and D) are shown. The cardiac cross-sectional area and transverse cardiac diameters are smaller at inspiration (A) than at expiration (B). Based on reconstructed coronal images (C, inspiratory; D, expiratory), the diaphragm is dislocated downward during inspiration and the cardiac long axis leans vertically (C) compared with expiration (D). Note that reconstructed coronal images are shown as a reference and were not used for analysis in the study.
Mentions: The maximum cardiac CSA based on CT was significantly smaller at inspiration (7.35 cm2 ± 1.57) than at expiration (8.24 cm2 ± 7.35) (p < 0.0001, Table 1). Also, the maximum transverse cardiac diameter was smaller at inspiration (11.6 cm ± 1.3) than at expiration (12.1 cm ± 1.4, p < 0.0001) (Fig 2).

Bottom Line: Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01).CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001).The CTR is also significantly influenced by ventilation.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

ABSTRACT

Objective: The aim of this study was to investigate physiological changes in cardiac area and diameters between inspiratory and expiratory chest computed tomography (CT), and to assess their correlation with lung size change and influence on cardiothoracic ratio (CTR) measurements.

Materials and methods: The institutional review board of our institution approved this study, and informed consent was waived. Forty-three subjects underwent inspiratory and expiratory chest CT as part of routine clinical care. On both inspiratory and expiratory scans, lung volumes and maximum lung diameters (transverse and vertical directions) were measured. The maximum cardiac cross-sectional area (CSA) and the maximum transverse cardiac diameter were measured on both scans, and the CT-based CTR was calculated. Changes in the lung and cardiac measurements were expressed as the expiratory/inspiratory (E/I) ratios. Comparisons between inspiratory and expiratory measurements were made by the Wilcoxon signed-rank test. Correlations between the E/I ratios of lung and heart measurements were evaluated by Spearman's rank correlation analysis.

Results: Cardiac CSA and transverse cardiac diameter was significantly larger on expiratory than on inspiratory CT (p < 0.0001). Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01). CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001).

Conclusions: Heart size on chest CT depends on the phase of ventilation, and is correlated with changes in lung volume and craniocaudal lung diameter. The CTR is also significantly influenced by ventilation.

No MeSH data available.


Related in: MedlinePlus