Non-invasive indicators of pulmonary hypertension from pulmonary veins quantification in sickle cell disease

Pulmonary hypertension is a common cause of death among patients with sickle cell disease. This retrospective study investigates the use of pulmonary vein analysis to diagnose pulmonary hypertension non-invasively with CT-Angiography images. Ten images from patients with pulmonary hypertension were matched with controls. An adaptive fast marching approach is applied in order to segment the left atrium and pulmonary veins, followed by a geodesic active contour to isolate the atrium. The ostia of the pulmonary veins are determined by computing the skeleton and finding the intersections with the contour of the atrium. 96.3% of the ostia are identified correctly by the technique. The diameters of the veins are then measured and their sum is computed at fixed distances from the ostium. These quantitative indicators are significantly larger in patients as compared to controls (p-values < 0.01). Furthermore, the non-invasive estimations of the method present a high and significant correlation with the clinical hemodynamics measurements obtained from right heart catheterization.