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Videomorphometric Analysis of Hypoxic Pulmonary Vasoconstriction of Intra-pulmonary Arteries Using Murine Precision Cut Lung Slices
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Pulmonary Artery Vasoconstriction Due to Bronchial Obstruction
Thomas Saliba1, Hanna Salame1, Denis Tack1
1Epicura Hospital, BE.
Journal of the Belgian Society of Radiology
|May 18, 2022
Summary
Pulmonary artery vasoconstriction from ventilation/perfusion imbalance is rarely seen on CT scans. This case highlights an unusual CT finding of bronchial mucoid impaction linked to pulmonary artery vasoconstriction.
Area of Science:
- Radiology
- Pulmonary Medicine
- Medical Imaging
Background:
- Pulmonary artery (PA) vasoconstriction due to ventilation/perfusion (V/Q) mismatch is challenging to detect using computed tomography (CT).
- Accurate detection of V/Q imbalances is crucial for diagnosing and managing respiratory conditions.
Observation:
- An 85-year-old female presented with severe dyspnea and hypoxemia unresponsive to oxygen therapy.
- CT pulmonary angiography (CTPA) revealed extensive central bronchial mucoid impaction, obstructing all bronchi except the right upper lobe.
- Opacification was noted only in the right upper pulmonary veins.
Findings:
- The study observed a correlation between central bronchial obstruction and unilateral pulmonary vein opacification.
- This pattern is hypothesized to result from pulmonary artery vasoconstriction in the affected lung segments, driven by the V/Q mismatch.
- Computed tomography (CT) infrequently detects such pulmonary artery vasoconstriction.
Implications:
- This case illustrates a rare presentation of pulmonary artery vasoconstriction, typically undetectable by standard CTPA.
- It emphasizes the importance of considering unusual imaging-physiology correlations in complex respiratory cases.
- The findings suggest CTPA may reveal indirect signs of PA vasoconstriction in specific clinical scenarios.
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