State-of-the-art pulmonary arterial imaging – Part 2

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 361-375 ◽  
Author(s):  
Harold Goerne ◽  
Abhishek Chaturvedi ◽  
Sasan Partovi ◽  
Prabhakar Rajiah
Keyword(s):  
Pulmonary Artery ◽  
State Of The Art ◽  
Therapy Monitoring ◽  
Pulmonary Arteries ◽  
Imaging Modalities ◽  
Cross Sectional ◽  
Multiple Imaging ◽  
Cross Sectional Imaging ◽  
Pulmonary Arterial ◽  
Arterial Imaging

Abstract. Although pulmonary embolism is the most common abnormality of the pulmonary artery, there is a broad spectrum of other congenital and acquired pulmonary arterial abnormalities. Multiple imaging modalities are now available to evaluate these abnormalities of the pulmonary arteries. CT and MRI are the most commonly used cross-sectional imaging modalities that provide comprehensive information on several aspects of these abnormalities, including morphology, function, risk-stratification and therapy-monitoring. In this article, we review the role of state-of-the-art pulmonary arterial imaging in the evaluation of non-thromboembolic disorders of pulmonary artery.

State-of-the-art pulmonary arterial imaging – Part 1

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 345-359 ◽  
Author(s):  
Yuki Tanabe ◽  
Luis Landeras ◽  
Abed Ghandour ◽  
Sasan Partovi ◽  
Prabhakar Rajiah
Keyword(s):  
State Of The Art ◽  
Pulmonary Arteries ◽  
Pulmonary Angiography ◽  
Imaging Modalities ◽  
Nuclear Medicine Imaging ◽  
Multiple State ◽  
Pulmonary Arterial ◽  
Magnetic Resonance Imaging Mri ◽  
Acquired Abnormalities ◽  
Arterial Imaging

Abstract. The pulmonary arteries are affected by a variety of congenital and acquired abnormalities. Multiple state-of-the art imaging modalities are available to evaluate these pulmonary arterial abnormalities, including computed tomography (CT), magnetic resonance imaging (MRI), echocardiography, nuclear medicine imaging and catheter pulmonary angiography. In part one of this two-part series on state-of-the art pulmonary arterial imaging, we review these imaging modalities, focusing particularly on CT and MRI. We also review the utility of these imaging modalities in the evaluation of pulmonary thromboembolism.

scholarly journals Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography

2021 ◽  
Author(s):  
Sreenivasa Narayana Raju ◽  
Niraj Nirmal Pandey ◽  
Arun Sharma ◽  
Amarinder Singh Malhi ◽  
Siddharthan Deepti ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Bronchial Tree ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography ◽  
Imaging Evaluation ◽  
Cross Sectional ◽  
Clinical Background ◽  
Cross Sectional Imaging ◽  
Life Threatening ◽  
Pulmonary Arterial

AbstractPulmonary artery dilatation comprises a heterogeneous group of disorders. Early diagnosis is important as the presentation may be incidental, chronic, or acute and life threatening depending upon the etiology. Cross-sectional imaging plays an important role, with CT pulmonary angiography being regarded as the first line investigation in the evaluation of pulmonary artery pathologies. Moreover, effects of pulmonary artery lesions on proximal and distal circulation can also be ascertained with the detection of associated conditions. Special attention should also be given to the left main coronary artery and the trachea-bronchial tree as they may be extrinsically compressed by the dilated pulmonary artery. In context of an appropriate clinical background, CT pulmonary angiography also helps in treatment planning, prognostication, and follow-up of these patients. This review mainly deals with imaging evaluation of the pulmonary arterial dilatations on CT with emphasis on the gamut of etiologies in the adult as well as pediatric populations.

The pulmonary circulation: assessing pulmonary arteries and pulmonary veins

2018 ◽  
pp. 516-523
Author(s):  
Deane Yim ◽  
Lars Grosse-Wortmann
Keyword(s):  
Decision Making ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Flow Distribution ◽  
Morphological Data ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Pulmonary Arterial ◽  
Sectional Imaging ◽  
Anatomic Information

The pulmonary arteries and pulmonary veins can be challenging to image comprehensively with echocardiography. As a result, patients with suspected pulmonary arterial or venous abnormalities are often referred for cross-sectional imaging with cardiac magnetic resonance (CMR). In addition to providing detailed anatomic information, CMR also offers important information regarding flow distribution and flow patterns within the vessel. The haemodynamic and morphological data derived from CMR are important in decision-making and provide a roadmap for planning surgical or interventional approaches. This chapter focuses on the anatomy, pathophysiology, and imaging considerations of congenital or acquired pulmonary arterial and venous abnormalities that are commonly encountered in clinical practice.

A STUDY ON THE CORRELATION BETWEEN MORPHOLOGIC ANORMALIES AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN DILATED CARDIO-MYOPATHY

2011 ◽  
pp. 137-144
Author(s):  
Thi Ngoc Ha Hoang ◽  
Anh Vu Nguyen ◽  
Minh Loi Hoang ◽  
Cuu Long Nguyen ◽  
Thi Thuy Hang Nguyen
Keyword(s):  
Pulmonary Artery ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Arteries ◽  
Left Ventricular ◽  
University Hospital ◽  
Cross Sectional ◽  
X Ray ◽  
Key Words Dilated Cardiomyopathy

Purposes: Describe the morphological and diastolic function of left ventricular changes in the patients with dilated cardiomyopathy (DCM) on US, X-ray findings, and Evaluate the correlation between morphology and diastolic function of left ventricular. Materials and method: Cross sectional study from Dec 2009 to Aug 2010, on 39 patients with dilated cardiomyopathy were evaluated at the University Hospital of Hue College of Medical and Pharmaceutical. Results: 1. X-ray and US findings characteristics of DCM is significantly increased in diameter of L, H and mG; LVM, LVMI, LVDd and LAD. 2. The pression of pulmonary artery has been significantly increased with redistribution pulmonary arteries in 61.5% cases and 23.1% have reversed pulmonary artery distribution. 3. DCM have diastolic dysfunction in 100% patients, including severe disorders to 61.5%; the restrictive dysfunction has ratio E/A>2 and E/Em average was 23.89± 17.23. 4.The correlation between the morphology and function in DCM: the diameter of H and L on the X-ray, LAD and ratio LA/AO on US correlated with the level of diastolic dysfunction (p< 0.05). All three radiographic parameters on the radio standard (H, L, the index Cardio/Thoracic) and LVDd on US have negative correlated with EF and FS with p <0.05. Key words: dilated cardiomyopathy, diastolic dysfunction, cardiac tissue Doppler, reversed pulmonary artery distribution

scholarly journals Effects of acute Rho kinase inhibition on chronic hypoxia-induced changes in proximal and distal pulmonary arterial structure and function

2011 ◽  
Vol 110 (1) ◽  
pp. 188-198 ◽  
Author(s):  
Rebecca R. Vanderpool ◽  
Ah Ram Kim ◽  
Robert Molthen ◽  
Naomi C. Chesler
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Rho Kinase ◽  
Pressure Flow ◽  
Kinase Inhibition ◽  
Pulmonary Vasoconstriction ◽  
Pulsatile Pressure ◽  
Arterial Structure ◽  
Pulmonary Arterial ◽  
Induced Changes

Hypoxic pulmonary hypertension (HPH) is initially a disease of the small pulmonary arteries. Its severity is usually quantified by pulmonary vascular resistance (PVR). Acute Rho kinase inhibition has been found to reduce PVR toward control values in animal models, suggesting that persistent pulmonary vasoconstriction is the dominant mechanism for increased PVR. However, HPH may also cause proximal arterial changes, which are relevant to right ventricular (RV) afterload. RV afterload can be quantified by pulmonary vascular impedance, which is obtained via spectral analysis of pulsatile pressure-flow relationships. To determine the effects of HPH independent of persistent pulmonary vasoconstriction in proximal and distal arteries, we quantified pulsatile pressure-flow relationships before and after acute Rho kinase inhibition and measured pulmonary arterial structure with microcomputed tomography. In control lungs, Rho kinase inhibition decreased 0 Hz impedance (Z0), which is equivalent to PVR, from 2.1 ± 0.4 to 1.5 ± 0.2 mmHg·min·ml−1 ( P < 0.05) and tended to increase characteristic impedance (ZC) from 0.21 ± 0.01 to 0.22 ± 0.01 mmHg·min·ml−1. In HPH lungs, Rho kinase inhibition decreased Z0 ( P < 0.05) without affecting ZC. Microcomputed tomography measurements performed on lungs after acute Rho kinase inhibition demonstrated that HPH significantly decreased the unstressed diameter of the main pulmonary artery (760 ± 60 vs. 650 ± 80 μm; P < 0.05), decreased right pulmonary artery compliance, and reduced the frequency of arteries of diameter 50–100 μm (both P < 0.05). These results demonstrate that acute Rho kinase inhibition reverses many but not all HPH-induced changes in distal pulmonary arteries but does not affect HPH-induced changes in the conduit arteries that impact RV afterload.

Abstract 15120: Nanoparticle-Mediated Delivery of Pitavastatin into Small Pulmonary Arteies by Intravenous Administration Attenuated the Progression of Already Established Monocrotaline-induced Pulmonary Arterial Hypertension in Rats

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kenzo Ichimura ◽  
Tetsuya Matoba ◽  
Ryoji Nagahama ◽  
Kaku Nakano ◽  
Kenji Sunagawa ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Pulmonary Artery ◽  
Arterial Hypertension ◽  
Intravenous Administration ◽  
Pulmonary Arteries ◽  
Intratracheal Instillation ◽  
Poly Lactic Acid ◽  
Bolus Administration ◽  
Sprague Dawley ◽  
Pulmonary Arterial

Background: Pulmonary arterial hypertension (PAH) is an intractable disease of small pulmonary artery in which multiple pathogenetic factors are involved. We have previously reported that poly(lactic acid/glycolic acid) (PLGA) nanoparticle (NP)-mediated targeting of pitavastatin into lungs by intratracheal instillation attenuated the development of PAH. In the present study we examined the effects of intravenous treatment with pitavastatin-NPs on the progression of already established PAH induced by monocrotaline (MCT). Methods and Results: Male Sprague-Dawley rats (200 to 230 g) were injected subcutaneously with 60 mg/kg MCT to induce PAH. At day 17 after MCT injection when PAH had been already established, animals were randomly divided into 4 groups, which treated with intravenous daily bolus administration of the following drugs for consecutive 4 days from 17 to 20 days after MCT injection; 1) vehicle, 2) FITC-NPs, 3) pitavastatin alone (1, 3, 10 or 30 mg/kg), or 4) pitavastatin-NPs (containing 1 or 3 mg/kg pitavastatin). Treatment with pitavastatin-NPs, but not with pitavastatin alone attenuated the progression of established PAH (Fig. A) associated with the reduction of inflammation and small pulmonary artery remodeling (stenosis and obstruction of pulmonary arterial branches) (Fig. B). In trace experiments, intravenous administration of FITC-NPs revealed the targeting of FITC-NPs into small pulmonary artery in rats with MCT-induced PAH, but not in normal animals. Importantly, in a separate protocol, treatment with pitavastatin-NPs improved the survival rate at day 35 (30% in pitavastatin-NP group vs. 61% in FITC-NP group, P<0.05 by Kaplan-Meier). Conclusion: A novel NP-mediated targeting of pitavastatin into small pulmonary arteries by intravenous administration attenuated the progression of established PAH and improved survival associated with anti-inflammatory and anti-remodeling effects in a rat model of MCT-induced PAH.

scholarly journals Ultrasound of the pediatric chest

2019 ◽  
Vol 92 (1100) ◽  
pp. 20190058 ◽  
Author(s):  
Priscilla Joshi ◽  
Aishvarya Vasishta ◽  
Mayank Gupta
Keyword(s):  
Pleural Effusion ◽  
Imaging Modalities ◽  
Lung Ultrasonography ◽  
Cross Sectional ◽  
Clinical Exam ◽  
Alara Principle ◽  
Pediatric Chest ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
Cystic Masses

Cross-sectional imaging modalities like MRI and CT provide images of the chest which are easily understood by clinicians. However, these modalities may not always be available and are expensive. Lung ultrasonography (US) has therefore become an important tool in the hands of clinicians as an extension of the clinical exam, which has been underutilized by the radiologists. Reinforcement of the ALARA principle along with the dictum of “Image gently” have resulted in increased use of modalities which do not require radiation. Hence, ultrasound, which was earlier being used mainly to confirm the presence of pleural effusion as well as evaluate it and differentiate solid from cystic masses, is now being used to evaluate the lung as well. This review highlights the utility of ultrasound of the paediatric chest. It also describes the normal and abnormal appearances of the paediatric lung on ultrasound as well as the advantages and limitations of this modality.

Sex Differences in Right Ventricular-Vascular Coupling and Pulmonary Artery Impedance in Response to Chronic Hypoxia and Recovery

2012 ◽  
Author(s):  
Aiping Liu ◽  
Lian Tian ◽  
Diana M. Tabima ◽  
Naomi C. Chesler
Keyword(s):  
Pulmonary Artery ◽  
Chronic Hypoxia ◽  
Pulmonary Arteries ◽  
Pulmonary Artery Hypertension ◽  
Vascular Impedance ◽  
Female Predominance ◽  
Collagen Accumulation ◽  
Dominant Disease ◽  
Pulmonary Arterial

Pulmonary artery hypertension (PAH) is a female dominant disease (the female-to-male ratio is 4:1), characterized by small distal pulmonary arterial narrowing and large proximal arterial stiffening, which increase right ventricle (RV) afterload and ultimately lead to RV failure [1,2]. Our recent studies have shown that collagen accumulation induced by chronic hypoxia increases the stiffness of the large extralobar pulmonary arteries (PAs) [3], and affects pulmonary vascular impedance (PVZ) [4]. The role of collagen in the female predominance in developing PAH has not been explored to date.

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