Imaging in pulmonary hypertension, part 1: clinical perspectives, classification, imaging techniques and imaging...

Area of Science:

• Cardiology
• Radiology
• Pulmonology

Background:

• Pulmonary arterial hypertension (PAH) is a severe condition with high morbidity and mortality.
• PAH has varied causes, clinical signs, and treatments, including surgery and targeted therapies.
• Current classification groups pulmonary hypertension (PH) by similar pathophysiology and treatment approaches.

Purpose of the Study:

• To present a multimodality imaging algorithm for investigating patients with suspected pulmonary hypertension (PH).
• To highlight the crucial role of imaging in establishing a precise diagnosis of PH and guiding therapy.

Main Methods:

• Review of various imaging modalities for PH: chest radiograph, echocardiography, V/Q scintigraphy, CT, and MRI.
• Emphasis on the complementary roles and limitations of each imaging technique.
• Proposal of a multimodality-imaging algorithm for suspected PH investigation.

Main Results:

• Imaging is fundamental for precise PH diagnosis, complementing clinical features.
• CT and MRI offer comprehensive evaluation of the heart, circulation, and lung parenchyma.
• Different modalities are used at various diagnostic stages, often complementing each other.

Conclusions:

• A structured, multimodality imaging approach is essential for accurate PH diagnosis.
• Modern cross-sectional imaging (CT and MRI) provides comprehensive evaluation.
• The proposed algorithm aids in guiding diagnostic investigations for suspected PH, though practice may vary.