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Aluja Jaramillo F, Gutierrez FR, Díaz Telli FG, Yevenes Aravena S, Javidan-Nejad C, Bhalla S. Approach to Pulmonary Hypertension: From CT to Clinical Diagnosis. Radiographics 2018; 38:357-373. [PMID: 29432063 DOI: 10.1148/rg.2018170046] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pulmonary hypertension (PH) is a condition characterized by increased pressure in the pulmonary circulation. It may be idiopathic or arise in the setting of other clinical conditions. Patients with PH tend to present with nonspecific cardiovascular or respiratory symptoms. The clinical classification of PH was recently revised at the World Health Organization symposium in Nice, France, in 2013. That consensus statement provided an updated classification based on the shared hemodynamic characteristics and management of the different categories of PH. Some features seen at computed tomography (CT) can suggest a subtype or probable cause of PH that may facilitate placing the patient in the correct category. These features include findings in the pulmonary arteries (peripheral calcification, peripheral dilatation, eccentric filling defects, intra-arterial soft tissue), lung parenchyma (centrilobular nodules, mosaic attenuation, interlobular septal thickening, bronchiectasis, subpleural peripheral opacities, ground-glass opacities, diffuse nodules), heart (congenital lesions, left heart disease, valvular disease), and mediastinum (hypertrophied bronchial arteries). An approach based on identification of these CT features in patients with PH will allow the radiologist to play an important role in diagnosis and help guide the clinician in management of PH. ©RSNA, 2018.
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Affiliation(s)
- Felipe Aluja Jaramillo
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
| | - Fernando R Gutierrez
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
| | - Federico G Díaz Telli
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
| | - Sebastian Yevenes Aravena
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
| | - Cylen Javidan-Nejad
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
| | - Sanjeev Bhalla
- From the Department of Radiology, Country Scan, Carrera 16 # 84a - 09 Cons. 323, Bogotá, Colombia (F.A.J.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.R.G., C.J.N., S.B.); Department of Radiology, Hospital Austral de Buenos Aires, Pilar Centro, Buenos Aires, Argentina (F.G.D.T.); and Department of Radiology, Clínica Las Condes, Las Condes, Región Metropolitana, Chile (S.Y.A.)
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Abstract
Pulmonary hypertension is defined by a mean pulmonary artery pressure greater than 25 mm Hg. Chronic thromboembolic pulmonary hypertension (CTEPH) is defined as pulmonary hypertension in the presence of an organized thrombus within the pulmonary vascular bed that persists at least 3 months after the onset of anticoagulant therapy. Because CTEPH is potentially curable by surgical endarterectomy, correct identification of patients with this form of pulmonary hypertension and an accurate assessment of surgical candidacy are essential to provide optimal care. Patients most commonly present with symptoms of exertional dyspnea and otherwise unexplained decline in exercise capacity. Atypical chest pain, a nonproductive cough, and episodic hemoptysis are observed less frequently. With more advanced disease, patients often develop symptoms suggestive of right ventricular compromise. Physical examination findings are minimal early in the course of this disease, but as pulmonary hypertension progresses, may include nonspecific finding of right ventricular failure, such as a tricuspid regurgitation murmur, pedal edema, and jugular venous distention. Chest radiographs may suggest pulmonary hypertension, but are neither sensitive nor specific for the diagnosis. Radioisotopic ventilation-perfusion scanning is sensitive for detecting CTEPH, making it a valuable screening study. Conventional catheter-based pulmonary angiography retains an important role in establishing the presence and extent of chronic thromboembolic disease. However, computed tomographic and magnetic resonance imaging are playing a growing diagnostic role. Innovative technologies such as dual-energy computed tomography, dynamic contrast-enhanced magnetic resonance imaging, and optical coherence tomography show promise for contributing diagnostic information and assisting in the preoperative characterization of patients with CTEPH.
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Left Main Coronary Artery Compression in Patients With Pulmonary Arterial Hypertension and Angina. J Am Coll Cardiol 2017; 69:2808-2817. [DOI: 10.1016/j.jacc.2017.03.597] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/08/2017] [Accepted: 03/29/2017] [Indexed: 11/19/2022]
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Granger LA, Pariaut R, Vila J, Coulter CE, Rademacher N, Queiroz-Williams P. COMPUTED TOMOGRAPHIC MEASUREMENT OF THE MAIN PULMONARY ARTERY TO AORTIC DIAMETER RATIO IN HEALTHY DOGS: A COMPARISON TO ECHOCARDIOGRAPHICALLY DERIVED RATIOS. Vet Radiol Ultrasound 2016; 57:376-86. [PMID: 27059810 DOI: 10.1111/vru.12363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/23/2015] [Accepted: 01/05/2016] [Indexed: 01/07/2023] Open
Abstract
Indicators of pulmonary hypertension in dogs examined with thoracic computed tomography (CT) are not well established in the veterinary literature. In humans, the main pulmonary artery to aortic diameter ratio (MPA:Ao) measured via CT, has been shown to be more sensitive than echocardiographic variables for predicting presence and severity of pulmonary hypertension, in some cases. In veterinary literature, the MPA:Ao has been determined echocardiographically to have an upper limit of about 1:1. Measurement of this ratio has not been described in dogs using CT. The objectives of this cross-sectional, prospective study were to compare echocardiographic measurement of MPA:Ao with that obtained via CT, determine if measurement of MPA:Ao via CT is repeatable and reproducible, and determine the effect of respiration and contrast administration on the measurement of MPA:Ao via CT. Ten healthy dogs without pulmonary hypertension were anesthetized to undergo thoracic CT using three protocols and echocardiography. The MPA:Ao was measured three times by three observers for each of the three CT protocols and compared to echocardiographic measurements. The mean MPA:Ao measured among all observers and CT protocols was 1.108 ± 0.152 (SD). The effect of CT scan protocol on MPA:Ao significantly differed among the three methods (P = 0.0014), where expiratory scans had lower MPA:Ao than inspiratory scans. The ratio measured on inspiratory CT scans consistently overestimated MPA:Ao when compared to echocardiography (bias = 0.226). Findings did not support the echocardiographically derived upper limit of MPA:Ao as an upper limit for determination of main pulmonary arterial enlargement on CT.
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Affiliation(s)
- L Abbigail Granger
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
| | - Romain Pariaut
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
| | - Jorge Vila
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
| | - Cassaundra E Coulter
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
| | - Nathalie Rademacher
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
| | - Patricia Queiroz-Williams
- Department of Veterinary Clinical Sciences, Lousiana State University School of Veterinary Medicine, Baton Rouge, LA, 70803
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Lewis G, Hoey ETD, Reynolds JH, Ganeshan A, Ment J. Multi-detector CT assessment in pulmonary hypertension: techniques, systematic approach to interpretation and key findings. Quant Imaging Med Surg 2015; 5:423-32. [PMID: 26029645 DOI: 10.3978/j.issn.2223-4292.2015.01.05] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 01/22/2015] [Indexed: 01/03/2023]
Abstract
Pulmonary arterial hypertension (PAH) may be suspected based on the clinical history, physical examination and electrocardiogram findings but imaging is usually central to confirming the diagnosis, establishing a cause and guiding therapy. The diagnostic pathway of PAH involves a variety of complimentary investigations of which computed tomography pulmonary angiography (CTPA) has established a central role both in helping identify an underlying cause for PAH and assessing resulting functional compromise. In particular CTPA is considered as the gold standard technique for the diagnosis of thromboembolic disease. This article reviews the CTPA evaluation in PAH, describing CTPA techniques, a systematic approach to interpretation and spectrum of key imaging findings.
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Affiliation(s)
- Gareth Lewis
- 1 Department of Radiology, 2 Department of Cardiology, Heart of England NHS Trust, Birmingham, UK
| | - Edward T D Hoey
- 1 Department of Radiology, 2 Department of Cardiology, Heart of England NHS Trust, Birmingham, UK
| | - John H Reynolds
- 1 Department of Radiology, 2 Department of Cardiology, Heart of England NHS Trust, Birmingham, UK
| | - Arul Ganeshan
- 1 Department of Radiology, 2 Department of Cardiology, Heart of England NHS Trust, Birmingham, UK
| | - Jerome Ment
- 1 Department of Radiology, 2 Department of Cardiology, Heart of England NHS Trust, Birmingham, UK
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Thoracic Manifestation of Eisenmenger’s Syndrome in Adult Patients: A MDCT Review. Lung 2014; 193:173-81. [DOI: 10.1007/s00408-014-9681-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 12/21/2014] [Indexed: 10/24/2022]
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Portopulmonary hypertension: Improved detection using CT and echocardiography in combination. Eur Radiol 2014; 24:2385-93. [DOI: 10.1007/s00330-014-3289-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/27/2014] [Accepted: 06/24/2014] [Indexed: 12/13/2022]
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Das I, Kassamali R, Hoey ETD, Teoh JK, Pakala V, Ganeshan A. Assessment of right heart dilatation with magnetic resonance imaging and multidetector computed tomography angiography: spectrum of disease findings. Curr Probl Diagn Radiol 2013; 42:231-40. [PMID: 24159922 DOI: 10.1067/j.cpradiol.2013.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Right heart chamber enlargement can be caused by a diverse and heterogeneous group of conditions with highly varied clinical symptoms and signs. An appreciation of the pathophysiology, causes, and imaging features of right heart enlargement is paramount in recognizing and potentially ameliorating the development of right heart dysfunction or adverse cardiac events. Chest x-ray and transthoracic echocardiography have traditionally been, and still are, the mainstay in initial evaluation of right heart dilatation; however, recent advances in both multidetector computed tomography and cardiovascular magnetic resonance imaging now permit a comprehensive assessment of the causes and consequences of right heart dilatation.
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Affiliation(s)
- Indrajeet Das
- Department of Radiology, Heart of England NHS Trust, Birmingham, UK
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Tang Q, Liu M, Ma Z, Guo X, Kuang T, Yang Y. Non-invasive evaluation of hemodynamics in pulmonary hypertension by a Septal angle measured by computed tomography pulmonary angiography: Comparison with right-heart catheterization and association with N-terminal pro-B-type natriuretic peptide. Exp Ther Med 2013; 6:1350-1358. [PMID: 24255661 PMCID: PMC3829756 DOI: 10.3892/etm.2013.1324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/12/2013] [Indexed: 12/25/2022] Open
Abstract
The septal angle, an angle between the interventricular septum and the line connecting the sternum midpoint and thoracic vertebral spinous process, as measured by computed tomographic pulmonary angiography (CTPA), has been observed to be increased in patients with pulmonary hypertension (PH), but its meaning remains unclear. The aim of this study was to investigate the potential role of the septal angle in evaluating hemodynamics and its association with N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with PH. Patients with PH (n=106), including 76 with chronic thromboembolic pulmonary hypertension (CTEPH) and 30 with pulmonary artery hypertension (PAH), were retrospectively reviewed. The patients underwent CTPA prior to right-heart catheterization. The septal angle was measured on transversal CTPA images. Hemodynamic parameters were evaluated by right-heart catheterization. The level of plasma NT-proBNP was measured by enzyme-linked sandwich immunoassay. The septal angle had a moderate correlation with cardiac output (CO; r=−0.535, P=0.000) and a high correlation with pulmonary vascular resistance (PVR; r=0.642, P=0.000). The mean level of NT-proBNP in PH was 1,716.09±1,498.30 pg/ml, which correlated with the septal angle (r=0.693, P=0.000). In a stepwise forward regression analysis, the Septal angle was entered into the final equation for predicting PVR, leading to the following equation: PVR = 28.256 × Septal angle - 728.72. In CTEPH, the Septal angle strongly correlated with NT-proBNP (r=0.668, P=0.000) and PVR (r=0.676, P=0.000). In PAH, the Septal angle strongly correlated with NT-proBNP (r=0.616, P=0.003) and PVR (r=0.623, P=0.000). The CTPA-derived Septal angle is a superior predictor for evaluating and monitoring the level of NT-proBNP and PVR in patients with PH.
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Affiliation(s)
- Qiang Tang
- Department of Cardiology, Shougang Hospital, Peking University, Beijing 100144, P.R. China
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Sauvage N, Reymond E, Jankowski A, Prieur M, Pison C, Bouvaist H, Ferretti GR. ECG-gated computed tomography to assess pulmonary capillary wedge pressure in pulmonary hypertension. Eur Radiol 2013; 23:2658-65. [DOI: 10.1007/s00330-013-2911-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/23/2013] [Accepted: 05/07/2013] [Indexed: 11/29/2022]
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Abstract
Pulmonary hypertension (PH) is the remarkable hemodynamic consequence of widespread structural and functional changes within the pulmonary circulation. Elevated pulmonary vascular resistance leads to increased mean pulmonary arterial pressure and, ultimately, right ventricular dysfunction. PH carries a poor prognosis and warrants timely and accurate diagnosis for appropriate intervention. The 2008 Dana Point classification system provides the categorical framework currently guiding therapy and surveillance. Radiologic imaging is an essential tool in the detection and diagnostic evaluation of patients with PH. Echocardiography, ventilation-perfusion scintigraphy, multidetector computed tomography, and cardiac magnetic resonance imaging provide insights into vascular morphology, pulmonary parenchymal status, cardiac function, and underlying etiology of the disorder. Emerging techniques of functional pulmonary and cardiac imaging hold great promise for the assessment and monitoring of these patients in the future.
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Affiliation(s)
- Aletta Ann Frazier
- Department of Diagnostic Radiology, University of Maryland Medical System, Baltimore, MD 21201, USA.
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Huang X, Pu X, Dou R, Guo X, Yan Z, Zhang Z, Li M, Jiang H, Lu B. Assessment of right ventricular function with 320-slice volume cardiac CT: comparison with cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 2012. [PMID: 23179750 DOI: 10.1007/s10554-012-0156-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To evaluate the accuracy and feasibility of right ventricular function parameters measurement using 320-slice volume cardiac CT. Retrospective analysis of 50 consecutive patients (23 men, 27 women) with suspected pulmonary diseases was performed in electrocardiogram (ECG)-gated cardiac CT and cardiac magnetic resonance (CMR). Parameters including right ventricular end-diastolic volume (RVEDV), right ventricular end- systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular cardiac output (RVCO), and right ventricular ejection fraction (RVEF) were semi-automatically and separately calculated from both CT and CMR data. Significant difference between measurements was measured by paired t test and two-variable linear regression analysis with Pearson's correlation coefficient. Bland-Altman analysis was performed in each pair of parameters. There was little variability between the measurements by the two observers (kappa = 0.895-0.980, P < 0.05). There was good correlation between all parameters obtained by CT and CMR (P < 0.001): RVEDV (108.5 ± 21.9 ml, 113.5 ± 24.8 ml, r = 0.944), RVESV (69.8 ± 33.4 ml, 73.2 ± 35.4 ml, r = 0.972), RVSV (39.0 ± 13.2 ml, 40.2 ± 13.3 ml, r = 0.977), RVCO (2.6 ± 0.7 l, 2.6 ± 0.7 l. r = 0.958), RVEF (38.8 ± 19.1 %, 39.1 ± 19.3 %, r = 0.990), and there was no significant difference between CT and CMR measurements in RVEF (n = 50, t = -0.677, P > 0.05). 320-slice volume cardiac CT is an accurate non-invasive technique to evaluate RV function.
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Affiliation(s)
- Xiaoyong Huang
- Department of Radiology, Anzhen Hospital/Capital Medicine of University, Anzhen Road No. 2, Chaoyang District, Beijing, China
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Computed tomography findings of pulmonary venoocclusive disease in scleroderma patients presenting with precapillary pulmonary hypertension. ACTA ACUST UNITED AC 2012; 64:2995-3005. [DOI: 10.1002/art.34501] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Current Role of Imaging in the Diagnosis and Management of Pulmonary Hypertension. AJR Am J Roentgenol 2012; 198:1320-31. [DOI: 10.2214/ajr.11.7366] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Peña E, Dennie C, Veinot J, Muñiz SH. Pulmonary Hypertension: How the Radiologist Can Help. Radiographics 2012; 32:9-32. [DOI: 10.1148/rg.321105232] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Comprehensive MDCT evaluation of patients with pulmonary hypertension: diagnosing underlying causes with the updated Dana Point 2008 classification. AJR Am J Roentgenol 2011; 197:W471-81. [PMID: 21862775 DOI: 10.2214/ajr.10.5417] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Pulmonary hypertension is a challenge for imagers and clinicians, with a variety of possible underlying causes, each with its own specific treatment. Although the diagnosis is based on physiologic measurements, ECG-gated MDCT can play a vital role in elucidating underlying cardiac, vascular, and pulmonary causes. CONCLUSION A revised system for pulmonary hypertension, the Dana Point classification, can provide a template for review of the myriad causes of this complex condition.
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Okajima Y, Ohno Y, Washko GR, Hatabu H. Assessment of pulmonary hypertension what CT and MRI can provide. Acad Radiol 2011; 18:437-53. [PMID: 21377593 DOI: 10.1016/j.acra.2011.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 01/06/2011] [Accepted: 01/12/2011] [Indexed: 01/06/2023]
Abstract
RATIONALES AND OBJECTIVES Pulmonary hypertension (PH) is a life-threatening condition, characterized by elevated pulmonary arterial pressure, which is confirmed based on invasive right heart catheterization (RHC). Noninvasive examinations may support diagnosis of PH before proceeding to RHC and play an important role in management and treatment of the disease. Although echocardiography is considered a standard tool in diagnosis, recent advances have made computed tomography (CT) and magnetic resonance (MR) imaging promising tools, which may provide morphologic and functional information. In this article, we review image-based assessment of PH with a focus on CT and MR imaging. CONCLUSIONS CT may provide useful morphologic information for depicting PH and seeking for underlying diseases. With the accumulated technological advancement, CT and MRI may provide practical tools for not only morphologic but also functional assessment of patients with PH.
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Affiliation(s)
- Yuka Okajima
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Ley S, Grünig E, Kiely DG, van Beek E, Wild J. Computed tomography and magnetic resonance imaging of pulmonary hypertension: Pulmonary vessels and right ventricle. J Magn Reson Imaging 2011; 32:1313-24. [PMID: 21105137 DOI: 10.1002/jmri.22373] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Pulmonary hypertension (PH) is very heterogeneous and the classification identifies five major groups including many associated disease processes. The treatment of PH depends on the underlying cause and accurate classification is paramount. A comprehensive assessment to identify the cause and severity of PH is therefore needed. Furthermore, follow-up assessments are required to monitor changes in disease status and response to therapy. Traditionally, the diagnostic imaging work-up of PH comprised mainly echocardiography, invasive right heart catheterization, and ventilation/perfusion scintigraphy. Due to technical advances, multidetector row computed tomography (CT) and magnetic resonance imaging (MRI) have become important and complementary investigations in the evaluation of patients with suspected PH. Both modalities are reviewed and recommendations for clinical use are given.
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Affiliation(s)
- Sebastian Ley
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
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Hoey ET, Nagra I, Ganeshan A. Cardiac Aneurysms and Diverticula: Magnetic Resonance and Computed Tomography Appearances. Curr Probl Diagn Radiol 2011; 40:72-84. [DOI: 10.1067/j.cpradiol.2010.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sánchez Nistal M. Hipertensión pulmonar: aportación de la TCMD al diagnóstico de sus distintos tipos. RADIOLOGIA 2010; 52:500-12. [DOI: 10.1016/j.rx.2010.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 05/25/2010] [Accepted: 05/29/2010] [Indexed: 11/16/2022]
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Sánchez Nistal M. Pulmonary hypertension: The contribution of MDCT to the diagnosis of its different types. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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