[Radiologic diagnosis of the hemodynamic situation in the pulmonary circulation in chronic obstructive ventilatory...

Hemodynamic consequences, especially in view of a developing pulmonary hypertension are essential factors regarding the course and prognosis of an obstructive airflow disturbance. The characteristic roentgen symptoms of pulmonary vascular changes in a group of patients are collected and statistically evaluated to find those symptoms correlating best with the results of cardiac catheterisation. The importance of using not a single symptom but characteristic groups of symptoms for the radiological diagnosis of pulmonary hypertension is stressed. Radiological signs of increased pulmonary pressure do not directly correlate to the degree of measurements, false positive radiological reports need not be expected. Positive radiological symptoms indicate irreversible anatomical changes in pulmonary circulation. For the individual patient the pulmonary arterial pressure by cardiac catheterisation alone is not sufficient for the diagnosis and prognosis of this case as in obstructive air-way disturbance two definitely different types of diseases, namely type A (emphysema) and type B (bronchitis) with divergent hemodynamic consequences must be distinguished. For this differentiation the radiological evaluation of the anatomical situation is essential.