CTICasesChronic Thromboembolic Pulmonary Hypertension
Imaging findings
Contrast-enhanced chest CT shows findings of severe pulmonary hypertension, including a dilated pulmonary artery, right ventricular free-wall hypertrophy, and right atrial enlargement with bowing of the interatrial septum. There is also eccentric, chronic thromboembolic material in the lobar and segmental pulmonary arteries, manifesting as webs and stenoses, with associated mosaic perfusion in the lung parenchyma and matched segmental defects on ventilation-perfusion scan.
Key takeaways
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary hypertension caused by non-resolving thromboemboli in the pulmonary arteries. Key diagnostic CT features include eccentric vascular narrowing, webs, bands, and mosaic perfusion. Unlike acute pulmonary embolism, CTEPH results in severe right ventricular remodeling and is potentially curable with pulmonary endarterectomy.
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