CTICasesPulmonic Valvular Stenosis with Post-Stenotic Dilation of the Main and Left Pulmonary Arteries
Imaging findings
A chest radiograph shows a prominent left hilar opacity. The lateral projection confirms a dilated left pulmonary artery. CT sagittal views show a dilated main pulmonary artery and a significantly enlarged left pulmonary artery, correlating nicely with the radiograph. The pulmonic valve leaflets appear thickened and immobile, highly suggestive of valvular stenosis on a non-gated study. Lower lobe pulmonary arteries converge towards the enlarged left pulmonary artery, demonstrating the hilar convergent sign.
Key takeaways
Pulmonic valvular stenosis typically causes post-stenotic dilation of the main pulmonary artery and often the left pulmonary artery due to the jet effect. The hilar convergent sign on a chest radiograph can help differentiate an enlarged pulmonary artery from a mass or lymphadenopathy. Thickened, non-moving pulmonic valves on CT, even non-gated, strongly suggest valvular stenosis in the appropriate clinical context.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Iatrogenic RV Perforation with Hemopericardium from Retained Thrombolysis CatheterIatrogenic
- Acquired Ventricular Septal Defect (VSD) with Possible Pericardial Rupture Post-MIVascular
- Coarctation of the Aorta with Classic '3 Sign'Congenital
- Spinal HemangioblastomaNeoplastic
- Short Telomere Syndrome with UIP Pattern, Cirrhosis, Splenomegaly, and Hepatopulmonary SyndromeILD
- Reverse Takotsubo Cardiomyopathy Secondary to ParagangliomaNeoplastic
- Intrathoracic Gastric Herniation with Pseudo-Pneumothorax Post-Hiatal Hernia RepairOther
- Anomalous Left Superior Pulmonary Vein Drainage (Variant Anatomy)Congenital
See all cases from September 30, 2016 →
Related Congenital cases
- Situs Inversus with Polysplenia and Bilateral Left-Sided Bronchial Anatomy
- Gorham-Stout Disease (Generalized Lymphatic Anomaly) with Bony Anomalies
- Congenital Absence of Right Pulmonary Artery with Ipsilateral Destroyed Lung (Likely Tuberculosis)
- Large Coronary Artery Fistula from RCA to Right Atrium (Follow-up)
- Meandering Pulmonary Vein with Anomalous Connection to Right Innominate Vein
- Anomalous Left Main Coronary Artery Arising from RCA with Fistula to Coronary Sinus