Lung perfused blood volume (PBV) imaging on dual-energy CT demonstrated multiple subpleural wedge-shaped defects in all 3 patients with PTTM, suggesting its usefulness for antemortem diagnosis.
Case Report (n=3)
Does lung perfused blood volume imaging on dual-energy CT aid in the antemortem diagnosis of pulmonary tumor thrombotic microangiopathy?
Lung perfused blood volume imaging on dual-energy CT may be a useful non-invasive tool for the challenging antemortem diagnosis of pulmonary tumor thrombotic microangiopathy.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a specific type of tumor embolism in the small and medium pulmonary arteries, leading to rapid progressive pulmonary hypertension. Antemortem diagnosis of PTTM is extremely difficult. We encountered three patients who were histopathologically or clinically diagnosed with PTTM. In all cases, lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) demonstrated multiple subpleural wedge-shaped defects with no evidence of pulmonary embolism on CT pulmonary angiography. The lung PBV images demonstrated small pulmonary arterial obstruction reflecting the pathology of PTTM. Therefore, lung PBV imaging would be useful for antemortem diagnosis of PTTM.
Kamada et al. (Wed,) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) (n=3). Lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) was evaluated on Subpleural wedge-shaped defects on lung PBV images. Lung perfused blood volume (PBV) imaging on dual-energy CT demonstrated multiple subpleural wedge-shaped defects in all 3 patients with PTTM, suggesting its usefulness for antemortem diagnosis.