Keywords:
Pulmonary vessels, Thorax, Cardiovascular system, CT-Angiography, Catheter arteriography, CT, Diagnostic procedure, Catheters, Surgery, Embolism / Thrombosis, Haemodynamics / Flow dynamics, Hyperplasia / Hypertrophy
Authors:
A. J. Theruvath1, G. Wirth1, T. Bostel2, E. Mayer1, C. Düber1, K.-F. Kreitner1; 1Mainz/DE, 2Heidelberg/DE
Purpose
Chronic thromboembolic pulmonary hypertension (CTEPH) is a relatively rare but serious sequela of acute pulmonary thromboembolism (PE).
Incomplete resolution of pulmonary emboli and secondary pulmonary small vessel arteriopathy are the main causes of vascular occlusion leading to CTEPH [1-4]. Depending on the extent of obstructed pulmonary arteries,
patients develop various degrees of pulmonary hypertension (PH) and right ventricular failure [4]. If left untreated patients show a poor prognosis.
[2,
5,
6]. CTEPH can be curatively treated by pulmonary endarterectomy (PEA) when lesions are not located distal to the origin of segmental lung arteries.
High-quality imaging is needed for diagnosis and planning of therapy. Digital subtraction angiography (DSA) and right-sided heart catheterization (RHC) are still regarded as diagnostic reference standard,
but limited access,
limited expertise,
and a small but definite patient risk on one side and improvements in cross-sectional imaging modalities are the impetus behind the use of multidetector-computed tomography angiography in the diagnostic work-up of the disease [7-10].
To date,
only a few studies analyzed the diagnostic role of ECG-gated CT in patients with CTEPH using MD-CTA versus DSA and RHC [8,
11,
12].
In this present study we compare the diagnostic performance of morphological and functional parameters with a 256-slice-CT compared with DSA and RHC.