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[Systematic evaluation of the pulmonary circulation with computerized tomography: normal and post-embolic pathologic
F Falaschi1, A Palla, L Battolla
1Cattedra di Radiologia, Università degli Studi di Pisa, Ospedale Santa Chiara.
La Radiologia Medica
|September 1, 1993
Summary
Computed tomography (CT) effectively diagnoses pulmonary circulation issues. A higher ratio of segmental artery to bronchus diameter indicates abnormal pulmonary blood flow, aiding diagnosis in embolism and hypertension patients.
Area of Science:
- Radiology
- Cardiovascular Medicine
- Pulmonology
Background:
- Pulmonary circulation abnormalities can result from thromboembolic events.
- Accurate diagnosis of pulmonary embolism and chronic thromboembolic pulmonary hypertension is crucial for patient management.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) in assessing pulmonary circulation in normal subjects and patients with pulmonary embolism.
- To identify CT-based imaging biomarkers for pulmonary hypertension and circulatory dysfunction.
Main Methods:
- Chest CT, including high-resolution CT and angio-CT, was performed on 8 normal subjects, 3 patients with acute pulmonary embolism, and 8 patients with chronic thromboembolic pulmonary hypertension.
- Pulmonary arteries, parenchyma, and bronchial arteries were analyzed.
- Correlation between CT measurements (arterial diameters, artery-to-bronchus ratio, lung density) and pulmonary artery systolic pressure (measured by right heart catheterization) was assessed.
Main Results:
- CT identified thrombi in acute pulmonary embolism (3/3) and chronic thromboembolic pulmonary hypertension (4/8).
- Main and interlobar pulmonary artery diameters correlated significantly with systolic pulmonary artery pressure (p < 0.001).
- A markedly higher ratio of segmental artery to bronchus caliber was observed in both acute pulmonary embolism and chronic thromboembolic pulmonary hypertension groups compared to controls. Bronchial artery dilation was noted in 4/8 chronic cases. Increased lung density in the perihilar region was seen in chronic thromboembolic pulmonary hypertension.
Conclusions:
- CT is a valuable tool for diagnosing pathological pulmonary circulation.
- The ratio of segmental artery to bronchus diameter is a promising imaging biomarker for evaluating pulmonary blood circulation abnormalities, particularly in thromboembolic disease.