Pulmonary arteries and lung parenchyma in chronic pulmonary embolism: preoperative and postoperative CT findings.

Abstract

To evaluate the role of computed tomography (CT) in diagnosis of chronic thromboembolic pulmonary hypertension, assessment of surgical operability, and follow-up after surgery. Seventy-five patients with chronic thromboembolism were examined with CT; 63 underwent thromboendarterectomy, and postoperative CT scans were acquired in 23. CT scans were analyzed for vascular and parenchymal changes, and findings were compared with those on lung scintigrams and with surgical results. CT findings allowed confirmation of the diagnosis of chronic thromboembolism and ensured technical operability (sensitivity, 77%; specificity, 100%; overall accuracy, 80%) by means of direct visualization of thrombi in central pulmonary arteries in 53 patients. CT enables demonstration of pulmonary thromboembolism with criteria pertaining to pulmonary arteries and to lung parenchyma and enables assessment of technical operatibility and confirmation of surgical success.