-To highlight the role of imaging in chronic thromboembolic pulmonary hypertension (CTEPH),
not only for diagnosing but also for characterizing diseases that can mimic it,
because the treatment as well as prognostic in such cases are substantially different.
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable causes of pulmonary hypertension and is definitively treated with pulmonary thromboendarterectomy.
The key benefit of imaging is the ability to demostrate the location and extent of obstructive disease which in conjunction with clinical and physiological data,
allows the experienced multidisciplinary team comprising physicians,
radiologist and surgeons to select the appropriate patients for surgical intervention.
Therefore knowledge of the conventional and less common radiologic features,
including mimics is crucial.
CTEPH is defined as a mean...
Findings and procedure details
CT characteristic features of CHRONIC PULMONARY THROMBOEMBOLISM can be classified in:
VASCULAR SIGNS: include
direct pulmonary artery signs (result in thrombus organization)
signs due to pulmonary hypertension (result of the sustained increase in pulmonary vascular resistance)
signs due to systemic collateral supply (results of decrease pulmonary artery flow)
a mosaic perfusion pattern,
focal ground glass opacities,
air trapping and bronchial dilatation.
DIRECT PULMONARY ARTERY SIGNS:
Complete oclussion: abrupt decrease in vessel diameter and absence of contrast material in the vessel...
The sistematic analysis of imaging,
specially CT pulmonary angiography,
plays a key role in differentiating CTEPH from other conditions that can give rise to similar imaging appearences. It is very important because early recognition may improve the outcome,
since CTEPH is potencially curable with thromboendarterectomy.
Marina Aurora Depetris.
Department of Radiology,
Hospital Universitario 12 de Octubre.
Avda de Córdoba s/n 28041,
Tel:0034-91-390-80-00 Fax: 91-469-57-75
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