Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients.

Purpose: To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations.Materials and Methods: Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alteration...

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Publicado en:European Radiology Vol. 27; no. 4; pp. 1631 - 1640
Autores principales: Giordano, Jessica, Khung, Suonita, Duhamel, Alain, Hossein-Foucher, Claude, Bellèvre, Dimitri, Lamblin, Nicolas, Remy, Jacques, Remy-Jardin, Martine
Formato: Journal Article
Publicado: Springer Nature Apr2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-016-4500-6
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        atl: Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients.
      aug:
        au:
          Giordano, Jessica
          Khung, Suonita
          Duhamel, Alain
          Hossein-Foucher, Claude
          Bellèvre, Dimitri
          Lamblin, Nicolas
          Remy, Jacques
          Remy-Jardin, Martine
        affil: Department of Thoracic Imaging , Hospital Calmette (EA 2694) , CHRU et Université de Lille 2 Nord de France 59000 Lille France
      sug:
        subj:
          Hypertension, Pulmonary
          Pulmonary Embolism
          Pulmonary Embolism Complications
          Male
          Adult
          Young Adult
          Tomography, X-Ray Computed Methods
          Aged, 80 and Over
          Middle Age
          Chronic Disease
          Hypertension, Pulmonary Etiology
          Female
          Diagnosis, Differential
          Perfusion Imaging Methods
          Angiography Methods
          Aged
          Adult: 19-44 years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations.Materials and Methods: Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12).Results: CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p < 0.0001): (1) in group 1, 96.6 % of segments with abnormal perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2.Conclusion: Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy.Key Points: • Depiction of chronic pulmonary embolism exclusively located on peripheral arteries is difficult. • The main differential diagnosis of pCTEPH is PAH. • The pattern of DECT perfusion changes can help differentiate PAH and pCETPH. • In PAH, almost all segments with abnormal perfusion showed patchy defects. • In pCTEPH, patchy and PE-type defects were the most frequent abnormalities.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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