Chronic Thromboembolic Pulmonary Hypertension: Pre- and Postoperative Assessment with Breath-hold MR Imaging Techniques

Radiology ◽  
2004 ◽  
Vol 232 (2) ◽  
pp. 535-543 ◽  
Author(s):  
Karl-Friedrich Jakob Kreitner ◽  
Sebastian Ley ◽  
Hans-Ulrich Kauczor ◽  
Eckhard Mayer ◽  
Thorsten Kramm ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mr Imaging ◽  
Imaging Techniques ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Breath Hold ◽  
Postoperative Assessment ◽  
Thromboembolic Pulmonary Hypertension

scholarly journals Mimickers of chronic thromboembolic pulmonary hypertension on imaging tests: a review

2020 ◽  
Vol 10 (1) ◽  
pp. 204589401988262
Author(s):  
Shraddha Narechania ◽  
Rahul Renapurkar ◽  
Gustavo A. Heresi
Keyword(s):  
Pulmonary Hypertension ◽  
Imaging Techniques ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Artery Sarcoma ◽  
Radiological Features ◽  
Thromboembolic Pulmonary Hypertension ◽  
Perfusion Defects ◽  
Perfusion Scan

Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by mechanical obstruction of large pulmonary arteries secondary to one or more episodes of pulmonary embolism. Ventilation perfusion scan is the recommended initial screening test for this condition and typically shows multiple large mismatched perfusion defects. However, not all patients with an abnormal ventilation perfusion scan have CTEPH since there are other conditions that be associated with a positive ventilation perfusion scan. These conditions include in situ thrombosis, pulmonary artery sarcoma, fibrosing mediastinitis, pulmonary vasculitis and sarcoidosis, among others. Although these conditions cannot be distinguished from CTEPH using a ventilation perfusion scan, they have certain characteristic radiological features that can be demonstrated on other imaging techniques such as computed tomography scan and can help in differentiation of these conditions. In this review, we have summarized some key clinical and radiological features that can help differentiate CTEPH from the CTEPH mimics.

scholarly journals Depiction of mosaic perfusion in chronic thromboembolic pulmonary hypertension (CTEPH) on C-arm computed tomography compared to computed tomography pulmonary angiogram (CTPA)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabine K. Maschke ◽  
Thomas Werncke ◽  
Cornelia L. A. Dewald ◽  
Lena S. Becker ◽  
Timo C. Meine ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Imaging Techniques ◽  
Intraclass Correlation ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Observer Agreement ◽  
Vascular Lesions ◽  
Pulmonary Angiogram ◽  
Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Arterial

AbstractTo evaluate mosaic perfusion patterns and vascular lesions in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using C-Arm computed tomography (CACT) compared to computed tomography pulmonary angiography (CTPA). We included 41 patients (18 female; mean age 59.9 ± 18.3 years) with confirmed CTEPH who underwent CACT and CTPA within 21 days (average 5.3 ± 5.2). Two readers (R1; R2) independently evaluated datasets from both imaging techniques for mosaic perfusion patterns and presence of CTEPH-typical vascular lesions. The number of pulmonary arterial segments with typical findings was evaluated and the percentage of affected segments was calculated and categorized: < 25%; 25–49%; 50–75%; < 75% of all pulmonary arterial segments affected by thromboembolic vascular lesions. Inter-observer agreement was calculated for both modalities using the intraclass-correlation-coefficient (ICC). Based on consensus reading the inter-modality agreement (CACTcons vs. CTPAcons) was calculated using the ICC. Inter-observer agreement was excellent for central vascular lesions (ICC > 0.87) and the percentage of affected segments (ICC > 0.76) and good for the perceptibility of mosaic perfusion (ICC > 0.6) and attribution of the pattern of mosaic perfusion (ICC > 0.6) for both readers on CACT and CTPA. Inter-modality agreement was excellent for the perceptibility of mosaic perfusion (ICC = 1), the present perfusion pattern (ICC = 1) and central vascular lesions (ICC = 1). However, inter-modality agreement for the percentage of affected segments was fair (ICC = 0.50), with a greater proportion of identified affected segments on CACTcons. CACT demonstrates a high agreement with CTPA regarding the detection of mosaic perfusion. CACT detects a higher number of peripheral vascular lesions compared to CTPA.

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