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Chronic thromboembolic pulmonary hypertension: evaluation with 64-detector row CT versus digital substraction

Angela Reichelt1, Marius M Hoeper, Michael Galanski

  • 1Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Str. 1, Hannover 30625, Germany. Reichelt.Angela@mh-hannover.de

European Journal of Radiology
|May 9, 2008
PubMed

Insights

64-row CT accurately diagnoses chronic thromboembolic pulmonary hypertension (CTEPH). This non-invasive imaging is a reliable alternative to digital subtraction angiography (DSA) for CTEPH evaluation.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Pulmonary Medicine

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) requires accurate diagnosis for effective management.
  • Digital subtraction angiography (DSA) is the conventional reference standard but is invasive.

Purpose of the Study:

  • To assess the diagnostic performance of 64-row computed tomography (CT) in identifying CTEPH.
  • To compare CT findings with DSA in patients suspected of having CTEPH.

Main Methods:

  • Retrospective, blinded analysis of CT and DSA studies from 27 patients with suspected CTEPH.
  • Evaluation of main, lobar, and segmental pulmonary arteries using axial images and multiplanar maximum intensity projections (MIPs).

Main Results:

  • CT demonstrated high sensitivity (98.3%) and specificity (94.8%) for main/lobar CTEPH changes.
  • CT showed excellent sensitivity (84.3-90.5%) and specificity (92-98.7%) for segmental changes and specific CTEPH criteria.
  • CT provided an overview comparable to DSA, aiding in image interpretation.

Conclusions:

  • 64-row CT is an accurate and reliable non-invasive tool for diagnosing CTEPH.
  • CT can serve as a valuable alternative to invasive DSA in the diagnostic workup of CTEPH patients.

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