scholarly journals Effectiveness of Dual-Energy Computed Tomography in Providing Information on Pulmonary Perfusion and Vessel Morphology in Chronic Thromboembolic Pulmonary Hypertension

2015 ◽  
Vol 79 (11) ◽  
pp. 2517-2519 ◽  
Author(s):  
Hiroto Shimokawahara ◽  
Shun Ijuin ◽  
Norihito Nuruki ◽  
Masahiro Sonoda
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Dual Energy ◽  
Pulmonary Perfusion ◽  
Dual Energy Computed Tomography ◽  
Vessel Morphology ◽  
Thromboembolic Pulmonary Hypertension

scholarly journals EXPRESS: Evaluation of Microvasculopathy using Dual-Energy Computed Tomography in Patients with Chronic Thromboembolic Pulmonary Hypertension

2020 ◽  
pp. 204589402098316
Author(s):  
Hiroyuki Onishi ◽  
Yu Taniguchi ◽  
Yoichiro Matsuoka ◽  
Ken-ichi Yanaka ◽  
Yu Izawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Inverse Correlation ◽  
Dual Energy ◽  
Heart Catheterization ◽  
Interventional Treatment ◽  
Dual Energy Computed Tomography ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Impact

Introduction The existence of microvasculopathy in patients with chronic thromboembolic pulmonary hypertension (CTEPH) has been suggested. Recently dual-energy computed tomography (DE-CT) has been used to produce a sensitive iodine distribution map in lung fields to indicate microvasculopathy according to poor subpleural perfusion (PSP). Our aim was to evaluate the impact of microvasculopathy on pathophysiology in CTEPH. Methods According to the extent of PSP, 93 interventional treatment-naïve patients were divided into poorly perfused (n=49) or normally perfused group (n=44). We assessed cardiopulmonary exercise test, right heart catheterization, and DE-CT parameters for quantitative evaluation of lung perfusion of blood volume (lung PBV) score. Results Lung PBV score in normally perfused group was significantly inversely correlated with pulmonary vascular resistance (PVR) (PVR= 6816.1×lung PBV score -0.793, R² = 0.225, p<0.01), but　lung PBV score in poorly perfused group was not. Poorly perfused group had higher PVR (879±409 dynes-sec/cm5 vs. 574±279 dynes-sec/cm5, p<0.01) and lower lung PBV score (22.1±5.4 vs. 26.4±6.6, p<0.01) and %DLCO/VA (59.9±15.4% vs. 78.8±14.2%, p<0.01). Conclusions PBV score in the normally perfused group showed an inverse correlation with PVR; however, that in poorly perfused group did not. Microvasculopathy might contribute to severe hemodynamics, apart from pulmonary vascular obstruction. In our experience, more than half of treatment-naïve CTEPH patients have microvasculopathy.

scholarly journals Microvasculopathy evaluated by dual-energy computed tomography in chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Miwa ◽  
Y Taniguchi ◽  
K Sumimoto ◽  
Y Matsuoka ◽  
Y Izawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Hounsfield Unit ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Arterial

Abstract Background It has been previously reported that poor subpleural perfusion (PSP) in dual-energy computed tomography (DE-CT) might suggest the microvasculopathy in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, it remains unclear whether pathological findings of microvasculopathy in CTEPH and pulmonary arterial hypertension (PAH) are equivalent. The aim is to evaluate the microvasculopathy in CTEPH and PAH by using clinical parameters and DE-CT. Methods We retrospectively reviewed PSP (defined as subpleural spaces either not or minimally perfused in all segments) of consecutive treatment-naïve 89 CTEPH patients and 20 PAH patients who underwent DECT from Feb. 2015 to Dec. 2019. We also evaluated hemodynamic parameters and DE-CT parameters including quantitative evaluation of pulmonary blood volume (PBV) which was calculated as the average of entire lung iodine density. Results PSP was observed in 49.4% of patients in CTEPH group versus 5.0% in PAH group (p&lt;0.01). There were no significant differences in hemodynamics and lung PBV between CTEPH group and PAH group (mean pulmonary arterial pressure; 36.4±10.4mmHg vs 38.3±8.5mmHg p=0.464, pulmonary vascular resistance; 700±388dyne*sec/cm5 vs 805±440 dyne*sec/cm5 p=0.288, lung PBV; 24.9±6.4 Hounsfield Unit vs 22.0±6.6 Hounsfield Unit p=0.06, respectively), however diffusing capacity for carbon monoxide (%DLCO/VA) was significantly lower (69.5±16.8% vs 45.7±23.7% p&lt;0.01) in PAH group. Conclusion PSP in DE-CT, which was observed more frequently in patients with CTEPH, might suggest the different mechanism of microvasculopathy from PAH in patients with CTEPH. Microvasculopathy in CTEPH would be diffuse very distal thrombosis. DE-CT is effective modality to detect microvasculopathy of diffuse distal thrombosis in patients with CTEPH. DECT, Poor subpleural perfusion Funding Acknowledgement Type of funding source: None

scholarly journals Dual-Energy Computed Tomography of the Lung in COVID-19 Patients: Mismatch of Perfusion Defects and Pulmonary Opacities

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 870
Author(s):  
Saif Afat ◽  
Ahmed E. Othman ◽  
Konstantin Nikolaou ◽  
Sebastian Gassenmaier
Keyword(s):  
Computed Tomography ◽  
Dual Energy ◽  
Lung Damage ◽  
Rating System ◽  
Pulmonary Perfusion ◽  
Imaging Studies ◽  
Dual Energy Computed Tomography ◽  
Contrast Enhanced ◽  
Perfusion Defects

To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.

Sign in / Sign up

Export Citation Format

Share Document