European Radiology

, Volume 22, Issue 9, pp 1929–1936 | Cite as

Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography

  • Heon Lee
  • Seok Yeon Kim
  • Soo Jeong Lee
  • Jae Kyun Kim
  • Ryan P. Reddy
  • U. Joseph Schoepf



To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography.


104 patients (72.47 ± 13.64 years; 39 male) who had undergone chest CT and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived PASP of 25 mmHg. RV to LV volume ratios (RVV/LVV) were calculated. RVV/LVV was then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on chest CT was calculated.


In the hypertensive group, the mean PASP was 46.29 ± 14.42 mmHg (29-98 mmHg) and there was strong correlation between the RVV/LVV and PASP (R = 0.82, p < 0.001). The intraobserver and interobserver correlation coefficients for RVV/LVV were 0.990 and 0.892. RVV/LVV was 1.01 ± 0.44 (0.51-2.77) in the hypertensive and 0.72 ± 0.14 (0.52-1.11) in the normotensive group (P <0.05). With 0.9 as the cutoff for RVV/LVV, sensitivity and specificity for predicting pulmonary hypertension over 40 mmHg were 79.5 % and 90 %, respectively. The AUC for predicting pulmonary hypertension was 0.87


RV/LV volume ratios on chest CT correlate well with PASP estimated by echocardiography and can be used to predict pulmonary hypertension over 40 mmHg with high sensitivity and specificity.

Key Points

• Chest CT is widely used in patients who may have pulmonary hypertension.

• Cardiac ventricular volume ratios on chest CT correlate with pulmonary arterial systolic pressure.

• A R/L ventricular volume ratio >0.9 usually indicates pulmonary hypertension >40 mmHg.

• Information available on routine chest CT may help predict pulmonary hypertension.


Pulmonary hypertension Cor pulmonale Computed tomography Pulmonary artery pressure Cardiac ultrasound 



UJ Schoepf receives research support from and is a consultant for Bayer, Bracco, GE, Medrad, and Siemens. SJ Lee is an employee of TeraRecon Korea. The other authors have no conflict of interest to disclose.


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Heon Lee
    • 1
  • Seok Yeon Kim
    • 2
  • Soo Jeong Lee
    • 3
  • Jae Kyun Kim
    • 4
  • Ryan P. Reddy
    • 5
  • U. Joseph Schoepf
    • 5
    • 6
  1. 1.Department of RadiologySoon Chun Hyang UniversityBucheonRepublic of Korea
  2. 2.Department of CardiologySeoul Medical CenterSeoulRepublic of Korea
  3. 3.Terarecon KoreaSeoulRepublic of Korea
  4. 4.Department of RadiologyChung-Ang University College of MedicineSeoulRepublic of Korea
  5. 5.Department of Radiology and Radiological Science and Division of Cardiology, Department of MedicineMedical University of South CarolinaCharlestonUSA
  6. 6.Department of Radiology and Radiological ScienceMedical University of South CarolinaCharlestonUSA

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