Abstract
Pulmonary hypertension (PH) is a complex disorder and may be related to a variety of diseases. It may arise in association with chronic thromboembolic pulmonary hypertension (CTEPH) or pulmonary embolism (PE). Knowledge of the radiological features is required to characterize and accurately diagnose the conditions and may improve the outcome. This study was designed to evaluate the clinical characteristics and the computerized tomography angiography findings in patients with PH, PE and CTEPH. Contrast-enhanced CT scans were acquired in 55 Sudanese patients with PE, 20 patients with PH, 25 patients with CTEPH and 50 normal subjects who were considered as control group. The CT diagnostic criteria for all cases were characterized. The clinical signs, parenchymal abnormalities, pulmonary tree and cardiac segments in all groups were characterized and compared with the control group. The results showed that the most common clinical characteristics were found to be chest pain, dyspnea, lower limb swelling, tachycardia and syncope which were correlated significantly with the presence of the disease. In all patients groups, the pulmonary vascular segments, cardiac segments and lung parenchyma changes were detected and were significantly different from the normal control subjects at p ≤ 0.01. It was found that CT angiography has a significant role in the diagnostic evaluation of these groups of patients. CT imaging is acceptably used in diagnosis, defining cause, quantifying heart segments and parenchyma changes in order to assess the feasibility of surgery, monitoring and therapeutic planning.
Highlights
Pulmonary hypertension (PH) is a complex disorder [1]
A sample of 55 patients with clinically diagnosed as pulmonary embolism (PE) was enrolled, their mean ages were 54.20 ± 14.21 ranged from 28 - 95 years old and a sample of 20 patients with PH, mean ages were 60.4 ± 13.96 ranged from 29 - 75 years and 25 patients with chronic thromboembolic pulmonary hypertension (CTEPH) were enrolled, their mean ages were 61.24 ± 9.5 ranged from 47 - 85 years old. 50 normal subjects were considered as control, their mean ages was 50.7 ± 14.5 ranged from 21 - 76 years old
Our results suggest that right ventricle, right atrium dilation on computed tomography pulmonary angiography (CTPA) may represent an additional marker of severe PE, PH and CTEPH and such patients should be considered as being at increased risk of adverse outcome
Summary
Pulmonary hypertension (PH) is a complex disorder [1]. Definition of PH is based on shared pathophysiologyHow to cite this paper: Aloub, S.E.H., Ayad, C.E. and Elnabi, M.E.M.G. (2016) Findings Associated with Pulmonary Hypertension: CT Angiography Based Study. (2016) Findings Associated with Pulmonary Hypertension: CT Angiography Based Study. In patients with PAH, progressive narrowing of the small pulmonary arteries and arterioles results in increased pulmonary vascular resistance, which may lead to right ventricular failure. In the majority of symptomatic patients, more than 40% of the pulmonary vascular bed is obstructed [15] [16]. Patients with CTEPH are asymptomatic before their presentation with symptoms [15]-[18]. The clinical worsening corresponds to the loss of right ventricular functional capability. In these patients, pulmonary arterial pressure is elevated and right atria pressures are high [16]
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