scholarly journals P2757Assessment of lung perfusion by subtraction CT pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension in comparison with ventilation/perfusion SPECT/CT lung scintigraphy

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
A Demchenkova ◽  
T Veselova ◽  
A Ansheles ◽  
V Sergienko ◽  
T Martynyuk ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Angiography ◽  
Lung Perfusion ◽  
Lung Scintigraphy ◽  
Ct Pulmonary Angiography ◽  
Thromboembolic Pulmonary Hypertension ◽  
Perfusion Spect

scholarly journals Frequency of computed tomography abnormalities in patients with chronic thromboembolic pulmonary hypertension: a comparative study between lung perfusion scan and computed tomography pulmonary angiography

2021 ◽  
Vol 16 ◽  
Author(s):  
Ahmed Fathala ◽  
Alaa Aldurabi
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Angiography ◽  
Lung Perfusion ◽  
Computed Tomography Pulmonary Angiography ◽  
Thromboembolic Pulmonary Hypertension ◽  
Study Population ◽  
The Mean ◽  
Parenchymal Lung

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the leading causes of pulmonary hypertension. Diagnosis of CTEPH can be established using various imaging techniques, including ventilation-perfusion scintigraphy (VQ) and multidetector computed tomography pulmonary angiography (CTPA). The aim of this study was to determine the frequency of direct pulmonary vascular, parenchymal lung, and cardiac abnormalities on CTPA in patients with CTEPH and to compare the diagnostic accuracy of both VQ scan CTPA in detecting CTEPH.Methods: we retrospectively included 54 patients who had been referred for pulmonary hypertension service (20 males, 34 females). All patients had VQ scan and CTPA within 15 days and underwent pulmonary artery endarterectomy (PEA) thereafter. VQ scan were reported according to modified PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) criteria. CTPA was considered as diagnostic for CTEPH if it showed presence of thrombus, webs, stenosis, or perfusion lung abnormalities.Results: The mean age of the study population was 41±10 years. The mean pulmonary artery pressure was 53±13 mmHg. Fifty-three of 54 patients in the study population had high probability VQ scan and one patient had intermediate probability. CTPA was suggestive of CTEPH in all patients. The most frequent CTPA findings in the central pulmonary arteries and peripheral arteries were presence of thrombotic materials, abnormal vessel tapering and abrupt vessels-cut off (76% vs 65%, 67% vs 48%, and 48% vs 22%), respectively. The mosaic lung perfusion was present in 78% in the patients, and various cardiac morphology abnormalities were presents and most common was abnormal right to left ventricle ratio, 69%.Conclusion: Our findings indicate that both VQ scan and CTPA are highly sensitive for the detection of CTEPH confirmed by PEA. Most CTEPH patients had several pulmonary vascular, parenchymal lung and cardiac abnormalities. There was no sign with 100% sensitivity on CTPA for CTEPH detection.

scholarly journals Dynamic vascular changes in chronic thromboembolic pulmonary hypertension after pulmonary endarterectomy

2020 ◽  
Vol 10 (4) ◽  
pp. 204589402090788 ◽  
Author(s):  
Dieuwertje Ruigrok ◽  
Natalia J. Braams ◽  
Esther J. Nossent ◽  
Peter I. Bonta ◽  
Anco Boonstra ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Angiography ◽  
Vascular Lesions ◽  
Heart Catheterization ◽  
Pulmonary Endarterectomy ◽  
Ct Pulmonary Angiography ◽  
Thromboembolic Pulmonary Hypertension ◽  
Residual Pulmonary Hypertension

Residual pulmonary hypertension is an important sequela after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Recurrent thrombosis or embolism could be a contributor to this residual pulmonary hypertension but the potential extent of its role is unknown in part because data on incidence are lacking. We aimed to analyze the incidence of new intravascular abnormalities after pulmonary endarterectomy and determine hemodynamic and functional implications. A total of 33 chronic thromboembolic pulmonary hypertension patients underwent routine CT pulmonary angiography before and six months after pulmonary endarterectomy, together with right heart catheterization and exercise testing. New vascular lesions were defined as (1) a normal pulmonary artery before pulmonary endarterectomy and containing a thrombus, web, or early tapering six months after pulmonary endarterectomy or (2) a pulmonary artery already containing thrombus, web, or early tapering at baseline, but increasing six months after pulmonary endarterectomy. Nine of 33 (27%) chronic thromboembolic pulmonary hypertension patients showed new vascular lesions on CT pulmonary angiography six months after pulmonary endarterectomy. In a subgroup of patients undergoing CT pulmonary angiography 18 months after pulmonary endarterectomy, no further changes in lesions were noted. Hemodynamic and functional outcomes were not different between patients with and without new vascular lesions. New vascular lesions are common after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension; currently their origin, dynamics, and long-term consequences remain unknown.

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