EURORAD ESR

Case 15721

Chronic thromboembolic pulmonary hypertension: a review of imaging findings on ECG gated pulmonary circulation MDCTA

Author(s)
Irini Nikolaou1 , Vasileios Rafailidis 1, Constantinos Kouskouras1, George Giannakoulas 2 Anna Kalogera-Fountzila1

1. Department of Radiology, AHEPA University Hospital of Thessaloniki, Greece.
2. 1st Clinic of Cardiology, AHEPA University Hospital of Thessaloniki, Greece.
Email:irini_nik@hotmail.com
 
Patient
female, 63 year(s)
 
 
  • Figure 1
    ECG- gated coronal reformatted image

    Shows enlarged right pulmonary artery and a mural attached filling defect at its bifurcation branch (eccentric thrombus- arrowhead).

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 2
    ECG-gated axial MIP image in angiographic window.

    Show the partial intraluminal and attached to the vessel wall defects (arrowhead: webs, arrow: eccentric thrombus). Enlarged pulmonary artery trunk and abrupt angular narrowing of pulmonary artery branch is noted

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 3
    ECG- gated coronal MIP reformatted image in angiographic window

    Shows the enlarged left pulmonary artery and branches. Also noted small filling defects attached to the vessel wall.

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 4
    ECG- gated axial reformatted image in angiographic window

    Collateral arterial shunt in posterior basal segments of right lower lobe is shown (arrowhead

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 5
    Axial image in pulmonary window

    Mosaic pattern due to irregular perfusion. Hypo- and hyperperfused areas.

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 6
    ECG-gated axial image in angiographic window

    Enlarged bronchial arteries arising from thoracic aorta and coursing behind the carina.

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Embolism / Thrombosis;
     
     
Shows enlarged right pulmonary artery and a mural attached filling defect at its bifurcation branch (eccentric thrombus- arrowhead).
 
Show the partial intraluminal and attached to the vessel wall defects (arrowhead: webs, arrow: eccentric thrombus). Enlarged pulmonary artery trunk and abrupt angular narrowing of pulmonary artery branch is noted
 
Shows the enlarged left pulmonary artery and branches. Also noted small filling defects attached to the vessel wall.
 
Collateral arterial shunt in posterior basal segments of right lower lobe is shown (arrowhead
 
Mosaic pattern due to irregular perfusion. Hypo- and hyperperfused areas.
 
Enlarged bronchial arteries arising from thoracic aorta and coursing behind the carina.
 
 
 
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