Computed Tomographic Measurement Of The Main Pulmonary Artery To Aortic Diameter Ratio In Healthy Dogs: A Comparison To Echocardiographically Derived Ratios

Granger LA, Pariaut R, Vila J, et al.

Veterinary Radiology & Ultrasound 2016;57:376-386.

Indicators of pulmonary hypertension in dogs examined with thoracic computed tomography (CT) are not well established in the veterinary literature. In humans, the main pulmonary artery to aortic diameter ratio (MPA:Ao) measured via CT, has been shown to be more sensitive than echocardiographic variables for predicting presence and severity of pulmonary hypertension, in some cases. In veterinary literature, the MPA:Ao has been determined echocardiographically to have an upper limit of about 1:1. Measurement of this ratio has not been described in dogs using CT. The objectives of this cross-sectional, prospective study were to compare echocardiographic measurement of MPA:Ao with that obtained via CT, determine if measurement of MPA:Ao via CT is repeatable and reproducible, and determine the effect of respiration and contrast administration on the measurement of MPA:Ao via CT. Ten healthy dogs without pulmonary hypertension were anesthetized to undergo thoracic CT using three protocols and echocardiography. The MPA:Ao was measured three times by three observers for each of the three CT protocols and compared to echocardiographic measurements. The mean MPA:Ao measured among all observers and CT protocols was 1.108 ± 0.152 (SD). The effect of CT scan protocol on MPA:Ao significantly differed among the three methods (P = 0.0014), where expiratory scans had lower MPA:Ao than inspiratory scans. The ratio measured on inspiratory CT scans consistently overestimated MPA:Ao when compared to echocardiography (bias = 0.226). Findings did not support the echocardiographically derived upper limit of MPA:Ao as an upper limit for determination of main pulmonary arterial enlargement on CT.