ACCURACY OF PREDICTING PULMONARY BLOOD FLOW, PULMONARY ARTERIOLAR RESISTANCE AND PULMONARY VENOUS PRESSURE FROM CHEST ROENTGENOGRAMS

¹ From the Department of Radiology, University of Kentucky Medical Center, Lexington, Kentucky
² Roger Williams Hospital, Providence, Rhode Island
³ Orange County General Hospital, Orange, California

The roentgen findings from a study of the right half of posteroanterior chest roentgenograms of 340 patients with various types of heart disease, as well as individuals with no cardiac disorder, were correlated with cardiac catheterization data. Accepted roentgenologic criteria were used for detection of abnormal pulmonary blood flow, elevation of pulmonary arteriolar resistance and elevation of pulmonary venous pressure. Normal pulmonary blood flow, increased pulmonary blood flow and elevated pulmonary venous pressure were correctly identified in about 60 per cent of cases. Much less accuracy was achieved in identifying decreased pulmonary blood flow and elevated pulmonary arteriolar resistance. Roentgen changes were more frequently evident in patients with more severe hemodynamic abnormalities. More than a single hemodynamic disturbance in the same individual was never recognized, except in patients with the combination of elevated pulmonary arteriolar resistance and elevated pulmonary venous pressure. A discussion of these findings and brief comments on the roentgenologic iterature are included.

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