Imaging in pulmonary hypertension, part 1: clinical perspectives, classification, imaging techniques and imaging algorithm.
Pulmonary arterial hypertension (PAH) is an uncommon condition associated with significant morbidity and mortality. It has diverse aetiology with differing clinical presentations, imaging features and treatments that range from surgical treatment of proximal chronic thromboembolic disease to targete...
| Published in: | Postgraduate Medical Journal Vol. 88; no. 1039; pp. 271 - 280 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Published: |
Oxford University Press / USA
May2012
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104352844&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104352844 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00325473 4FZ jtl: Postgraduate Medical Journal issn: 00325473 maglogo: N pubinfo: dt: May2012 vid: 88 iid: 1039 pid: 622 pub: Oxford University Press / USA artinfo: ui: 104352844 2011524754 10.1136/postgradmedj-2011-130292 NLM22267542 104352844 ppf: 271 ppct: 9 formats: tig: atl: Imaging in pulmonary hypertension, part 1: clinical perspectives, classification, imaging techniques and imaging algorithm. aug: au: McCann C Gopalan D Sheares K Screaton N affil: Department of Radiology, Papworth Hospital, Papworth Everard, Cambridge CB23 3RE, UK. deepa.gopalan@btopenworld.com. sug: subj: Hypertension, Pulmonary Classification Hypertension, Pulmonary Diagnosis Hypertension, Pulmonary Etiology Hypertension, Pulmonary Physiopathology Lung Blood Supply Lung Pathology Lung Physiopathology Algorithms Angiography Methods Disease Management Echocardiography Methods Magnetic Resonance Imaging Methods Perfusion Imaging Methods Pulmonary Circulation Respiratory Function Tests Methods Tomography, X-Ray Computed Methods Vascular Resistance Ventilation-Perfusion Ratio ab: Pulmonary arterial hypertension (PAH) is an uncommon condition associated with significant morbidity and mortality. It has diverse aetiology with differing clinical presentations, imaging features and treatments that range from surgical treatment of proximal chronic thromboembolic disease to targeted medical therapies in small vessel disease. Current classification of pulmonary hypertension (PH) is clinically based and groups diseases with similar pathophysiological mechanisms and therapeutic approaches. Groupings include conditions characterised by diffuse small vessel diseases such as idiopathic PAH, PH secondary to chronic hypoxic lung disease, left sided cardiac disease, chronic large vessel obstruction such as chronic thromboembolic disease and a miscellaneous group of diseases. The physiological manifestation of all of these diseases is increased pulmonary vascular resistance and PAH and while clinical features may provide a clue to diagnosis imaging plays a fundamental role in establishing a precise diagnosis and therefore guides therapy. A broad range of imaging modalities is available for the patient with suspected PH including chest radiograph, echocardiography, ventilation/perfusion scintigraphy, catheter pulmonary angiography as well as cross-sectional CT and MRI. Each modality has its strengths and limitations and different techniques may be used at different stages of diagnostic investigation and frequently complement each other. For example, while MRI and echocardiography permit cardiac structural and functional assessment, CT pulmonary angiography provides exquisite morphological information about the proximal pulmonary vasculature and lung parenchyma but little functional information. Modern cross-sectional imaging techniques (CT and MRI) hold the promise of a comprehensive evaluation of the heart, circulation and lung parenchyma in PH. The authors present a multimodality-imaging algorithm for the investigation of patients with suspected PH though it is acknowledged that there is some variation in practice depending on availability of resources and expertise. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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