Evaluating the radiographic assessment of pulmonary venous hypertension in chronic heart disease
This study evaluated how accurately the chest film could be used to determine pulmonary capillary wedge pressure (PCW) in patients with chronic heart disease. Six experienced readers interpreted the erect posteroanterior chest radiographs of 50 patients whose measured PCWs ranged from 6 to 38 mm Hg....
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| Veröffentlicht in: | AJR, Am. J. Roentgenol.; (United States) Am. J. Roentgenol.; (United States), 1984-05, Vol.142 (5), p.877-884 |
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| container_title | AJR, Am. J. Roentgenol.; (United States) |
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| creator | Baumstark, A Swensson, RG Hessel, SJ Levin, DC Grossman, W Mann, JT, 3rd Abrams, HL |
| description | This study evaluated how accurately the chest film could be used to determine pulmonary capillary wedge pressure (PCW) in patients with chronic heart disease. Six experienced readers interpreted the erect posteroanterior chest radiographs of 50 patients whose measured PCWs ranged from 6 to 38 mm Hg. Direct numeric estimates of PCW from the films were closely related to measured levels of PCW (r = 0.675). This linear correlation increased to 0.81 when individual-reader variations were reduced by taking a "consensus" (mean) of the six readers' estimates for each case. A combination of the judged degree of pulmonary blood flow redistribution (PFR) and three particular signs of pulmonary venous hypertension (PVH), basal and perihilar vascular blurring and alveolar edema, adequately summarized the radiographic information about PCW. These combined judgments of PFR/PVH identified films from patients with higher and lower PCW levels as accurately as readers' numeric estimates of PCW. Other radiographic signs (enlargement of the heart and central pulmonary vessels and the presence of Kerley lines or pleural effusion) were also positively related to increases in PCW, but added little to the information provided by the PFR/PVH criteria. |
| doi_str_mv | 10.2214/ajr.142.5.877 |
| format | Article |
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Six experienced readers interpreted the erect posteroanterior chest radiographs of 50 patients whose measured PCWs ranged from 6 to 38 mm Hg. Direct numeric estimates of PCW from the films were closely related to measured levels of PCW (r = 0.675). This linear correlation increased to 0.81 when individual-reader variations were reduced by taking a "consensus" (mean) of the six readers' estimates for each case. A combination of the judged degree of pulmonary blood flow redistribution (PFR) and three particular signs of pulmonary venous hypertension (PVH), basal and perihilar vascular blurring and alveolar edema, adequately summarized the radiographic information about PCW. These combined judgments of PFR/PVH identified films from patients with higher and lower PCW levels as accurately as readers' numeric estimates of PCW. Other radiographic signs (enlargement of the heart and central pulmonary vessels and the presence of Kerley lines or pleural effusion) were also positively related to increases in PCW, but added little to the information provided by the PFR/PVH criteria.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/ajr.142.5.877</identifier><identifier>PMID: 6609566</identifier><language>eng</language><publisher>United States: Am Roentgen Ray Soc</publisher><subject>550602 - Medicine- External Radiation in Diagnostics- (1980-) ; 550900 - Pathology ; Adolescent ; Adult ; Aged ; BASIC BIOLOGICAL SCIENCES ; BIOMEDICAL RADIOGRAPHY ; BLOOD PRESSURE ; BODY ; CARDIOVASCULAR DISEASES ; CARDIOVASCULAR SYSTEM ; Central Venous Pressure ; Chronic Disease ; Coronary Disease - diagnostic imaging ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES ; DISEASES ; False Positive Reactions ; HEART ; Heart Diseases - complications ; Heart Diseases - diagnostic imaging ; Heart Valve Diseases - diagnostic imaging ; Humans ; HYPERTENSION ; Hypertension, Pulmonary - complications ; Hypertension, Pulmonary - diagnostic imaging ; Lung - blood supply ; Lung - diagnostic imaging ; MEDICINE ; Middle Aged ; NUCLEAR MEDICINE ; ORGANS ; PATHOLOGY ; PATIENTS ; Pulmonary Circulation ; Pulmonary Wedge Pressure ; Radiography ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; Regional Blood Flow ; Statistics as Topic ; SYMPTOMS ; VASCULAR DISEASES</subject><ispartof>AJR, Am. 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J. Roentgenol.; (United States)</title><addtitle>AJR Am J Roentgenol</addtitle><description>This study evaluated how accurately the chest film could be used to determine pulmonary capillary wedge pressure (PCW) in patients with chronic heart disease. Six experienced readers interpreted the erect posteroanterior chest radiographs of 50 patients whose measured PCWs ranged from 6 to 38 mm Hg. Direct numeric estimates of PCW from the films were closely related to measured levels of PCW (r = 0.675). This linear correlation increased to 0.81 when individual-reader variations were reduced by taking a "consensus" (mean) of the six readers' estimates for each case. A combination of the judged degree of pulmonary blood flow redistribution (PFR) and three particular signs of pulmonary venous hypertension (PVH), basal and perihilar vascular blurring and alveolar edema, adequately summarized the radiographic information about PCW. These combined judgments of PFR/PVH identified films from patients with higher and lower PCW levels as accurately as readers' numeric estimates of PCW. Other radiographic signs (enlargement of the heart and central pulmonary vessels and the presence of Kerley lines or pleural effusion) were also positively related to increases in PCW, but added little to the information provided by the PFR/PVH criteria.</description><subject>550602 - Medicine- External Radiation in Diagnostics- (1980-)</subject><subject>550900 - Pathology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>BASIC BIOLOGICAL SCIENCES</subject><subject>BIOMEDICAL RADIOGRAPHY</subject><subject>BLOOD PRESSURE</subject><subject>BODY</subject><subject>CARDIOVASCULAR DISEASES</subject><subject>CARDIOVASCULAR SYSTEM</subject><subject>Central Venous Pressure</subject><subject>Chronic Disease</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>DIAGNOSIS</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>False Positive Reactions</subject><subject>HEART</subject><subject>Heart Diseases - complications</subject><subject>Heart Diseases - diagnostic imaging</subject><subject>Heart Valve Diseases - diagnostic imaging</subject><subject>Humans</subject><subject>HYPERTENSION</subject><subject>Hypertension, Pulmonary - complications</subject><subject>Hypertension, Pulmonary - diagnostic imaging</subject><subject>Lung - blood supply</subject><subject>Lung - diagnostic imaging</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>NUCLEAR MEDICINE</subject><subject>ORGANS</subject><subject>PATHOLOGY</subject><subject>PATIENTS</subject><subject>Pulmonary Circulation</subject><subject>Pulmonary Wedge Pressure</subject><subject>Radiography</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Regional Blood Flow</subject><subject>Statistics as Topic</subject><subject>SYMPTOMS</subject><subject>VASCULAR DISEASES</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEFv1DAQRi0EKkvhyBHJ4sAtWzuOneSIqtIiVeJSJG7GsScbV4kdPE5X_fcY7YqeZg5vvtH3CPnI2b6ueXNlHtOeN_Ve7ru2fUV2XDaqErzhr8mOCcWrjolfb8k7xEfGWNv17QW5UIr1Uqkd-X3zZObNZB8ONE9Ak3E-HpJZJ2-pQQTEBUKmcaTrNi8xmPRMnyDEDen0vELKENDHQH2gdkoxlLMJTMrUeQSD8J68Gc2M8OE8L8nPbzcP13fV_Y_b79df7ysrGpWrhnVqUNZ1vRRcmLpvmRyaVjhratd21o2s7sbGGTcIK62V3DjFZN_LYShbKy7J51NuxOw1Wp_BTjaGADbrlnHJGC_QlxO0pvhnA8x68Whhnk2A0kh3nMlaSFnA6gTaFBETjHpNfindNWf6n3ZdtOuiXUtdtBf-0zl4GxZw_-mz55fHkz9MR59A42LmudBcH4_Hl6C_k42NKg</recordid><startdate>198405</startdate><enddate>198405</enddate><creator>Baumstark, A</creator><creator>Swensson, RG</creator><creator>Hessel, SJ</creator><creator>Levin, DC</creator><creator>Grossman, W</creator><creator>Mann, JT, 3rd</creator><creator>Abrams, HL</creator><general>Am Roentgen Ray Soc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>198405</creationdate><title>Evaluating the radiographic assessment of pulmonary venous hypertension in chronic heart disease</title><author>Baumstark, A ; Swensson, RG ; Hessel, SJ ; Levin, DC ; Grossman, W ; Mann, JT, 3rd ; Abrams, HL</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c346t-4086b6cd895313a29705b473dca2d78cdf028f4dadb3c5cc51ad605995bbad673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>550602 - Medicine- External Radiation in Diagnostics- (1980-)</topic><topic>550900 - Pathology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>BASIC BIOLOGICAL SCIENCES</topic><topic>BIOMEDICAL RADIOGRAPHY</topic><topic>BLOOD PRESSURE</topic><topic>BODY</topic><topic>CARDIOVASCULAR DISEASES</topic><topic>CARDIOVASCULAR SYSTEM</topic><topic>Central Venous Pressure</topic><topic>Chronic Disease</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>DIAGNOSIS</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DISEASES</topic><topic>False Positive Reactions</topic><topic>HEART</topic><topic>Heart Diseases - complications</topic><topic>Heart Diseases - diagnostic imaging</topic><topic>Heart Valve Diseases - diagnostic imaging</topic><topic>Humans</topic><topic>HYPERTENSION</topic><topic>Hypertension, Pulmonary - complications</topic><topic>Hypertension, Pulmonary - diagnostic imaging</topic><topic>Lung - blood supply</topic><topic>Lung - diagnostic imaging</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>NUCLEAR MEDICINE</topic><topic>ORGANS</topic><topic>PATHOLOGY</topic><topic>PATIENTS</topic><topic>Pulmonary Circulation</topic><topic>Pulmonary Wedge Pressure</topic><topic>Radiography</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Regional Blood Flow</topic><topic>Statistics as Topic</topic><topic>SYMPTOMS</topic><topic>VASCULAR DISEASES</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baumstark, A</creatorcontrib><creatorcontrib>Swensson, RG</creatorcontrib><creatorcontrib>Hessel, SJ</creatorcontrib><creatorcontrib>Levin, DC</creatorcontrib><creatorcontrib>Grossman, W</creatorcontrib><creatorcontrib>Mann, JT, 3rd</creatorcontrib><creatorcontrib>Abrams, HL</creatorcontrib><creatorcontrib>Harvard Medical School, Boston, MA</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>AJR, Am. J. Roentgenol.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baumstark, A</au><au>Swensson, RG</au><au>Hessel, SJ</au><au>Levin, DC</au><au>Grossman, W</au><au>Mann, JT, 3rd</au><au>Abrams, HL</au><aucorp>Harvard Medical School, Boston, MA</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluating the radiographic assessment of pulmonary venous hypertension in chronic heart disease</atitle><jtitle>AJR, Am. J. Roentgenol.; (United States)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>1984-05</date><risdate>1984</risdate><volume>142</volume><issue>5</issue><spage>877</spage><epage>884</epage><pages>877-884</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><abstract>This study evaluated how accurately the chest film could be used to determine pulmonary capillary wedge pressure (PCW) in patients with chronic heart disease. Six experienced readers interpreted the erect posteroanterior chest radiographs of 50 patients whose measured PCWs ranged from 6 to 38 mm Hg. Direct numeric estimates of PCW from the films were closely related to measured levels of PCW (r = 0.675). This linear correlation increased to 0.81 when individual-reader variations were reduced by taking a "consensus" (mean) of the six readers' estimates for each case. A combination of the judged degree of pulmonary blood flow redistribution (PFR) and three particular signs of pulmonary venous hypertension (PVH), basal and perihilar vascular blurring and alveolar edema, adequately summarized the radiographic information about PCW. These combined judgments of PFR/PVH identified films from patients with higher and lower PCW levels as accurately as readers' numeric estimates of PCW. Other radiographic signs (enlargement of the heart and central pulmonary vessels and the presence of Kerley lines or pleural effusion) were also positively related to increases in PCW, but added little to the information provided by the PFR/PVH criteria.</abstract><cop>United States</cop><pub>Am Roentgen Ray Soc</pub><pmid>6609566</pmid><doi>10.2214/ajr.142.5.877</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0361-803X |
| ispartof | AJR, Am. J. Roentgenol.; (United States), 1984-05, Vol.142 (5), p.877-884 |
| issn | 0361-803X 1546-3141 |
| language | eng |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | 550602 - Medicine- External Radiation in Diagnostics- (1980-) 550900 - Pathology Adolescent Adult Aged BASIC BIOLOGICAL SCIENCES BIOMEDICAL RADIOGRAPHY BLOOD PRESSURE BODY CARDIOVASCULAR DISEASES CARDIOVASCULAR SYSTEM Central Venous Pressure Chronic Disease Coronary Disease - diagnostic imaging DIAGNOSIS DIAGNOSTIC TECHNIQUES DISEASES False Positive Reactions HEART Heart Diseases - complications Heart Diseases - diagnostic imaging Heart Valve Diseases - diagnostic imaging Humans HYPERTENSION Hypertension, Pulmonary - complications Hypertension, Pulmonary - diagnostic imaging Lung - blood supply Lung - diagnostic imaging MEDICINE Middle Aged NUCLEAR MEDICINE ORGANS PATHOLOGY PATIENTS Pulmonary Circulation Pulmonary Wedge Pressure Radiography RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE Regional Blood Flow Statistics as Topic SYMPTOMS VASCULAR DISEASES |
| title | Evaluating the radiographic assessment of pulmonary venous hypertension in chronic heart disease |
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