A Stepwise Approach to Computed Tomography Imaging of Pulmonary Hypertension

Pulmonary hypertension (PH) refers to a disease condition with elevated mean pulmonary arterial pressure of more than 20 mm Hg. This may arise secondary to an underlying pathology involving the lungs, heart, or major vessels of the chest. Patients with PH can present with nonspecific cardiac or respiratory complaints. Although right heart catheterization is the gold standard for diagnosing PH, it is not always done or required and often, PH is diagnosed based on clinical suspicion and noninvasive tests such as echocardiography. Computed tomography (CT) scans play a vital role in diagnosing PH, detecting the severity of the disease, and discerning the etiological factors. A stepwise approach to review CT imaging of the thorax to aid in the diagnosis of PH and to look for the etiology and prognostic factors is described in this article.