Imaging of Chronic Thromboembolic Pulmonary Hypertension

Area of Science:

• Cardiology
• Radiology
• Pulmonology

Background:

• Chronic thromboembolic pulmonary hypertension (CTEPH) results from chronic pulmonary artery obstruction by organized thromboemboli.
• It is a significant cause of secondary pulmonary hypertension.
• Accurate diagnosis is critical for patient outcomes.

Purpose of the Study:

• To highlight the diagnostic challenges of CTEPH.
• To emphasize the importance of specific imaging modalities in CTEPH diagnosis.
• To differentiate CTEPH from acute pulmonary embolism and mimic conditions.

Main Methods:

• Review of imaging findings in CTEPH.
• Comparison of echocardiography, V/Q scans, and CT pulmonary angiography for CTEPH detection.
• Analysis of conditions that can mimic CTEPH.

Main Results:

• Echocardiography and V/Q scans are initial screening tools for CTEPH.
• CT scans may miss CTEPH diagnoses.
• Imaging findings for CTEPH and acute pulmonary embolism can overlap.
• Differential diagnoses include in situ thrombus, vasculitis, pulmonary artery sarcoma, and fibrosing mediastinitis.

Conclusions:

• Radiologists must consider CTEPH in patients with acute pulmonary embolism findings on CT.
• Concurrent chronic disease evaluation is essential.
• Timely and accurate diagnosis improves management of CTEPH.