Pulmonary hypertension: role of computed tomography and magnetic resonance imaging

Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) have a leading role in the diagnosis and evaluation of pulmonary arterial hypertension. Technical aspects, advantages, limitations and potential contraindications will be considered. MDCT has many advantages: 1) fast examination, 2) good identification of central and peripheral vessels, 3) good characterization of parenchymal findings, and 4) good evaluation of the heart and mediastinal structures. Limitations are: 1) the use of iodinated contrast material, and 2) radiation exposure. MRI allows: 1) cardiac morphological and functional studies, and 2) identification of central pulmonary arteries. Limitations are: 1) long scanning time, 2) poor definition of peripheral arteries, and 3) impossibility of pulmonary evaluation. MDCT and MRI findings allow: 1) quick diagnosis of pulmonary arterial hypertension, 2) differential diagnosis between primary and secondary forms, 3) evaluation of cardiac manifestations, and 4) morphological and functional follow-up studies in surgically treated and untreated patients.