Document Detail


CT diagnosis of chronic pulmonary thromboembolism.
MedLine Citation:
PMID:  19168835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic pulmonary thromboembolism is mainly a consequence of incomplete resolution of pulmonary thromboembolism. Increased vascular resistance due to obstruction of the vascular bed leads to pulmonary hypertension. Chronic thromboembolic pulmonary hypertension is clearly more common than previously was thought, and misdiagnosis is common because patients often present with nonspecific symptoms related to pulmonary hypertension. Computed tomography (CT) is a useful alternative to conventional angiography not only for diagnosing chronic pulmonary thromboembolism but also for determining which cases are treatable with surgery and confirming technical success postoperatively. The vascular CT signs include direct pulmonary artery signs (complete obstruction, partial obstruction, eccentric thrombus, calcified thrombus, bands, webs, poststenotic dilatation), signs related to pulmonary hypertension (enlargement of main pulmonary arteries, atherosclerotic calcification, tortuous vessels, right ventricular enlargement, hypertrophy), and signs of systemic collateral supply (enlargement of bronchial and nonbronchial systemic arteries). The parenchymal signs include scars, a mosaic perfusion pattern, focal ground-glass opacities, and bronchial anomalies. The presence of one or more of these radiologic signs arouses suspicion and allows diagnosis of this entity. Early recognition of chronic pulmonary thromboembolism may help improve the outcome, since the condition is potentially curable with pulmonary thromboendarterectomy.
Authors:
Eva Castañer; Xavier Gallardo; Eva Ballesteros; Marta Andreu; Yolanda Pallardó; Josep Maria Mata; Lluis Riera
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Publication Detail:
Type:  Introductory Journal Article    
Journal Detail:
Title:  Radiographics : a review publication of the Radiological Society of North America, Inc     Volume:  29     ISSN:  1527-1323     ISO Abbreviation:  Radiographics     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-03-26     Revised Date:  2010-11-22    
Medline Journal Info:
Nlm Unique ID:  8302501     Medline TA:  Radiographics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-50; discussion 50-3     Citation Subset:  IM    
Copyright Information:
(c) RSNA, 2009.
Affiliation:
Department of Radiology, UDIAT-Centre Diagnòstic, Institut Universitari Parc Taulí-UAB, Parc Taulí s/n, Sabadell 08208, Barcelona, Spain. ecastaner@tauli.cat
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MeSH Terms
Descriptor/Qualifier:
Angiography / methods*
Chronic Disease
Humans
Pulmonary Embolism / radiography*
Radiographic Image Enhancement / methods*
Tomography, X-Ray Computed / methods*

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