CTICasesIn-Situ Thrombus in Methamphetamine-Induced Pulmonary Hypertension
Imaging findings
CT in a methamphetamine user shows severe right ventricular hypertrophy and layering, eccentric in-situ thrombus lining the main, left, and right pulmonary arteries. Swirling contrast (smoke artifact) is present. V/Q scan shows no mismatched perfusion defects, ruling out CTEPH.
Key takeaways
Pulmonary arterial hypertension secondary to methamphetamine use can lead to sluggish pulmonary blood flow, predisposing patients to the development of layering, eccentric in-situ thrombosis in the main and lobar pulmonary arteries. This must be distinguished from surgical CTEPH.
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