Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension

Abstract:  There is often a two-year delay in the diagnosis of Pulmonary Hypertension (PH) because the initial symptoms (dyspnoea and fatigue) are frequently attributed to other comorbidities. In addition, it is diagnosed by an invasive technique:  right heart catheterization&...

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Autores principales: Díaz, EM, Carrillo , C, Juárez , J, Lladser , G, Lipchak , P, Rodes , O, Lewis , D, Castrillon , ME
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/34864
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id I10-R327-article-34864
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
format Artículo revista
topic pulmonary hypertension
egg and banana
diameter of the main pulmonary artery
Computed Tomography
Hipertensión pulmonar
huevo y banana
diámetro de la arteria pulmonar principal
tomografía computada
.
spellingShingle pulmonary hypertension
egg and banana
diameter of the main pulmonary artery
Computed Tomography
Hipertensión pulmonar
huevo y banana
diámetro de la arteria pulmonar principal
tomografía computada
.
Díaz, EM
Carrillo , C
Juárez , J
Lladser , G
Lipchak , P
Rodes , O
Lewis , D
Castrillon , ME
Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
topic_facet pulmonary hypertension
egg and banana
diameter of the main pulmonary artery
Computed Tomography
Hipertensión pulmonar
huevo y banana
diámetro de la arteria pulmonar principal
tomografía computada
.
author Díaz, EM
Carrillo , C
Juárez , J
Lladser , G
Lipchak , P
Rodes , O
Lewis , D
Castrillon , ME
author_facet Díaz, EM
Carrillo , C
Juárez , J
Lladser , G
Lipchak , P
Rodes , O
Lewis , D
Castrillon , ME
author_sort Díaz, EM
title Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
title_short Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
title_full Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
title_fullStr Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
title_full_unstemmed Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
title_sort egg and banana sign: a new diagnostic ct marker for pulmonary hypertension
description Abstract:  There is often a two-year delay in the diagnosis of Pulmonary Hypertension (PH) because the initial symptoms (dyspnoea and fatigue) are frequently attributed to other comorbidities. In addition, it is diagnosed by an invasive technique:  right heart catheterization  (RHC), responsible for the appearance of adverse events such as arrhythmias, hypotension and pneumothorax, among others. Non-invasive tests are playing an important role in early detection. A tomographic marker, the egg and banana sign (EBS) was recently introduced, which could contribute to the diagnosis.  Objectives: To determine if EBS is a sensitive and specific diagnostic marker for PH. To re-evaluate the correlation between the principal diameter of the pulmonary artery (PA) and the pulmonary artery-ascending aorta ratio (PA-Ao ratio) both individually and in combination with EBS.  A total of 42 patients were evaluated who, between 2017 and 2021, underwent RHC and CT that included the aortic arch. Two blind observers determined whether EBS was present or absent on CT scans. Qualitative data were described using absolute and relative frequencies, ROC curves. The Chi Square test was performed for the association between variables. P <0.05 was considered statistically significant. The work was approved by the Departamento de Investigación y Docencia del Hospital Italiano de Córdoba. Of the total number of patients, 19 had PH and 23 were control subjects. 75% of the patients in whom EBS was observed had PH with an average mPAP of 39 mmHg (Sensitivity: 62%; Specificity: 88.24%; P: 0.036). Regarding the PA, EBS was observed in patients with a diameter greater than 32 mm, with an average of 40mm. (Sensitivity: 75%; Specificity: 82%; p = 0.0001). Of the patients with PH, 74% had a PA-Ao ratio greater than 1 (p: 0.0034).  Conclusion:  in our population EBS presented a high specificity for mPAP from 39 mmHg. In association with the diameter of the PA, the classic marker, both its sensitivity and specificity were high.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2021
url https://revistas.unc.edu.ar/index.php/med/article/view/34864
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spelling I10-R327-article-348642024-04-15T16:19:09Z Egg and banana sign: a new diagnostic ct marker for pulmonary hypertension Signo del huevo y la banana: un novedoso marcador diagnóstico de tc para la hipertensión pulmonar A Díaz, EM Carrillo , C Juárez , J Lladser , G Lipchak , P Rodes , O Lewis , D Castrillon , ME pulmonary hypertension egg and banana diameter of the main pulmonary artery Computed Tomography Hipertensión pulmonar huevo y banana diámetro de la arteria pulmonar principal tomografía computada . Abstract:  There is often a two-year delay in the diagnosis of Pulmonary Hypertension (PH) because the initial symptoms (dyspnoea and fatigue) are frequently attributed to other comorbidities. In addition, it is diagnosed by an invasive technique:  right heart catheterization  (RHC), responsible for the appearance of adverse events such as arrhythmias, hypotension and pneumothorax, among others. Non-invasive tests are playing an important role in early detection. A tomographic marker, the egg and banana sign (EBS) was recently introduced, which could contribute to the diagnosis.  Objectives: To determine if EBS is a sensitive and specific diagnostic marker for PH. To re-evaluate the correlation between the principal diameter of the pulmonary artery (PA) and the pulmonary artery-ascending aorta ratio (PA-Ao ratio) both individually and in combination with EBS.  A total of 42 patients were evaluated who, between 2017 and 2021, underwent RHC and CT that included the aortic arch. Two blind observers determined whether EBS was present or absent on CT scans. Qualitative data were described using absolute and relative frequencies, ROC curves. The Chi Square test was performed for the association between variables. P <0.05 was considered statistically significant. The work was approved by the Departamento de Investigación y Docencia del Hospital Italiano de Córdoba. Of the total number of patients, 19 had PH and 23 were control subjects. 75% of the patients in whom EBS was observed had PH with an average mPAP of 39 mmHg (Sensitivity: 62%; Specificity: 88.24%; P: 0.036). Regarding the PA, EBS was observed in patients with a diameter greater than 32 mm, with an average of 40mm. (Sensitivity: 75%; Specificity: 82%; p = 0.0001). Of the patients with PH, 74% had a PA-Ao ratio greater than 1 (p: 0.0034).  Conclusion:  in our population EBS presented a high specificity for mPAP from 39 mmHg. In association with the diameter of the PA, the classic marker, both its sensitivity and specificity were high. Resumen:  A menudo se produce un retraso de dos años en el diagnóstico de Hipertensión Pulmonar (HP) porque los síntomas iniciales (disnea y fatiga) se atribuyen con frecuencia a otras comorbilidades. Además, se diagnostica mediante una técnica invasiva: el cateterismo cardiaco derecho (CCD), responsable de la aparición de eventos adversos como  arritmias, hipotensión y neumotórax, entre otros. Las pruebas no invasivas están desempeñando un papel más importante en la detección precoz. Se introdujo recientemente un marcador tomográfico, el signo de huevo y la banana (SHB), que podría contribuir en el diagnóstico.  Objetivos: Determinar si el SHB es un marcador diagnóstico sensible y específico para la HP. Reevaluar la correlación entre el diámetro principal de arteria pulmonar (AP) y la relación de arteria pulmonar-aorta ascendente (relación AP-Ao) tanto individualmente como en combinación con el SHB.  Se evaluó un total de 42 pacientes que, entre  2017 a 2021, se realizaron CCD y se sometieron a TC que incluyeran el arco aórtico.  Dos observadores ciegos determinaron si el SHB estaba presente o ausente en las TC. Los datos cualitativos se describieron utilizando frecuencias absolutas y relativas, se realizaron curvas ROC, y para la asociación entre las variables se realizó test de Chi2. P <0,05 se consideró significativo. El trabajo fue aprobado por el Departamento de Investigación y Docencia del Hospital Italiano de Córdoba. Del total de pacientes, 19 tenían HP y 23 representaron los sujetos control. El 75% de los pacientes en los que se observó el SHB presentaba HP con una PAPm  promedio de 39 mmHg (Sensibilidad: 62%; Especificidad: 88,24%; p: 0,036). Con respecto a la AP, se observó el SHB en pacientes con un diámetro mayor a 32mm, con un promedio de 40mm. (Sensibilidad: 75%; Especificidad: 82%; p= 0,0001). De los pacientes con HP el 74% tenían una relación AP-Ao mayor a 1 (p: 0,0034).  En conclusión, en nuestra población, el SHB presentó una alta especificidad para una PAPm a partir de 39 mmHg. En asociación con el diámetro de la AP, el marcador clásico, tanto su sensibilidad como la  especificidad fueron elevadas. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/34864 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0