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Published on: September 6, 2024
Chronic pulmonary embolism: diagnosis.
Katia Hidemi Nishiyama1, Sachin S Saboo2, Yuki Tanabe2
1Department of Thoracic Imaging, Hospital do Coração and DASA (Diagnósticos da América), São Paulo, Brazil.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable condition. This review explores how various imaging techniques aid in diagnosing CTEPH, a complication of venous thromboembolic disease.
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.

