Computed tomography and other imaging techniques can help differentiate chronic thromboembolic pulmonary hypertension from mimicking conditions that also present with abnormal ventilation perfusion scans.
What are the key clinical and radiological features on imaging tests that help differentiate CTEPH from its mimickers?
While V/Q scans are the initial screening test for CTEPH, other imaging modalities like CT scans are essential to differentiate true CTEPH from mimickers such as pulmonary artery sarcoma or fibrosing mediastinitis.
Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by mechanical obstruction of large pulmonary arteries secondary to one or more episodes of pulmonary embolism. Ventilation perfusion scan is the recommended initial screening test for this condition and typically shows multiple large mismatched perfusion defects. However, not all patients with an abnormal ventilation perfusion scan have CTEPH since there are other conditions that be associated with a positive ventilation perfusion scan. These conditions include in situ thrombosis, pulmonary artery sarcoma, fibrosing mediastinitis, pulmonary vasculitis and sarcoidosis, among others. Although these conditions cannot be distinguished from CTEPH using a ventilation perfusion scan, they have certain characteristic radiological features that can be demonstrated on other imaging techniques such as computed tomography scan and can help in differentiation of these conditions. In this review, we have summarized some key clinical and radiological features that can help differentiate CTEPH from the CTEPH mimics.
Narechania et al. (Fri,) conducted a review in Chronic thromboembolic pulmonary hypertension. Imaging tests was evaluated. Computed tomography and other imaging techniques can help differentiate chronic thromboembolic pulmonary hypertension from mimicking conditions that also present with abnormal ventilation perfusion scans.