Pulmonary hypertension CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Richard Channick, M.D.; Assistant Editor(s)-in-Chief: Ralph Matar, Lisa Prior, Ann Slater, R.N.

Overview

CT scanning is a valuable, noninvasive procedure for confirming the presence of pulmonary hypertension. Different types of CT imaging have been used to rule out certain etiologies of pulmonary hypertension and to delineate the anatomy of the pulmonary vasculature.

CT

  • Contrast-enhanced images may show intraluminal abnormalities in the arteries and veins, which are useful for confirming etiologies such as thromboembolic disease.
  • Spiral CT scan in a patient with pulmonary hypertension can also reveal enlarged pulmonary arteries and an absence of thrombosis.
    • The upper limit of normal for the diameter of the pulmonary artery is 28.6 mm. A value greater than 28.6 mm suggests increased pressures in the pulmonary system.[1]
  • CT scan is 100% specific for the diagnosis of pulmonary veno-occlusive disease (PVOD).[2] The characteristics findings of PVOD on CT scan are:[2]
    • Subpleural thickened septal lines
    • Centrilobular ground-glass opacities (vs panlobular opacities in idiopathic pulmonary arterial hypertension)
    • Adenopathy

Multi Sliced CT

Images shown below are courtesy of RadsWiki and copylefted.

CT-Scan of a Patient with Advanced Histiocytosis X Associated With Severe Pulmonary Hypertension[3]

References

  1. Pulmonary Hypertension Imaging,Author: Davinder Jassal, MD, FACC, FRCPC; Chief Editor: Eugene C Lin, MD
  2. 2.0 2.1 Resten A, Maitre S, Humbert M, Rabiller A, Sitbon O, Capron F; et al. (2004). "Pulmonary hypertension: CT of the chest in pulmonary venoocclusive disease". AJR Am J Roentgenol. 183 (1): 65–70. doi:10.2214/ajr.183.1.1830065. PMID 15208112.
  3. Severe Pulmonary Hypertension in Histiocytosis X,Am. J. Respir. Crit. Care Med., Volume 161, Number 1, January 2000, 216-223

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