CTICasesChronic Thromboembolic Pulmonary Hypertension
Imaging findings
Axial chest CT demonstrates chronic, organized, and heavily calcified thrombus in the right main pulmonary artery, accompanied by a mosaic lung perfusion pattern and tortuosity of the peripheral intercostal vessels. Marked dilation of the main pulmonary artery is present adjacent to the aortic arch, representing the banana sign of severe pulmonary hypertension.
Key takeaways
Chronic thromboembolic pulmonary hypertension (CTEPH) can present with extensive organized, calcified thrombi within the main pulmonary arteries, mosaic perfusion, and bronchial or systemic collateral artery hypertrophy. Recognizing the combinations of calcification, arterial dilation, and systemic arterial remodeling helps confirm CTEPH and differentiate it from acute thromboembolism.
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