Chronic pulmonary embolism: diagnosis

Area of Science:

• Cardiology
• Radiology
• Pulmonary Medicine

Background:

• Chronic thromboembolic pulmonary hypertension (CTEPH) arises from unresolved pulmonary emboli.
• Unlike other pulmonary hypertension forms, CTEPH is potentially curable via surgery or angioplasty.
• Accurate diagnosis is crucial for timely intervention in CTEPH.

Purpose of the Study:

• To review the diagnostic utility of various imaging modalities for CTEPH.
• To highlight the role of non-invasive imaging in conjunction with gold-standard methods.

Main Methods:

• Discussion of lung scintigraphy, CT, and MR angiography for non-invasive assessment.
• Emphasis on conventional pulmonary angiography (CPA) with right heart catheterization (RHC) as the gold standard.
• Integration of imaging findings for comprehensive CTEPH diagnosis.

Main Results:

• Non-invasive imaging (lung scintigraphy, CT, MR angiography) provides essential anatomic and functional data.
• These techniques complement CPA and RHC in characterizing CTEPH.
• Imaging facilitates surgical or interventional planning.

Conclusions:

• A combination of advanced imaging techniques is vital for accurate CTEPH diagnosis.
• Imaging supports the identification of surgically accessible disease.
• Multimodality imaging improves patient selection for curative treatments.