CTICasesChronic Pulmonary Thromboembolism (CTEPH)
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Imaging findings
Enlargement of the central and main pulmonary arteries is observed. There is marked hypertrophy of the right ventricle, with increased RV diameter and bowing of the interventricular septum, indicating long-standing pulmonary hypertension. Following the pulmonary arteries, eccentric filling defects and improved vessels are noted in both lower lobes. Hypertrophic bronchial collaterals are present, along with mosaic perfusion abnormalities on lung windows.
Key takeaways
This is a classic example of chronic pulmonary thromboembolism (CTEPH) causing severe pulmonary hypertension in a relatively young (46-year-old) patient. Notably, the patient had no antecedent history or symptoms suggestive of prior pulmonary embolism, highlighting that CTEPH can develop insidiously.
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