CTICasesChronic Thromboembolic Pulmonary Hypertension
Imaging findings
CT chest shows a dilated main pulmonary artery and a large, eccentric peripheral filling defect (mural thrombus) in the right pulmonary artery, measuring approximately 70 Hounsfield units. There is also associated right ventricular wall hypertrophy, with mild peripheral ground-glass opacities in the lungs.
Key takeaways
Chronic thromboembolic pulmonary hypertension (CTEPH) or chronic in-situ pulmonary artery thrombosis can cause severe pulmonary hypertension. Unlike acute pulmonary embolism, the thrombus in CTEPH typically layers eccentrically along the vessel wall, and the main pulmonary artery dilates significantly due to long-standing high pressure. Significant resolution can still occur with anticoagulation.
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