Chronic pulmonary embolism
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.View Yuranga Weerakkody's current disclosures
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Chronic pulmonary emboli are mainly a consequence of incomplete resolution of pulmonary thromboembolism.
- vascular CT signs include
- direct pulmonary artery signs
- signs related to pulmonary hypertension
- signs of systemic collateral supply
- enlargement of bronchial and non-bronchial systemic arteries 7,8
- parenchymal signs (often non-specific on their own):
Nuclear medicine: V/Q scan
Some publications suggest that V/Q scanning may be more sensitive 6,9 but less specific 9 than CTPA in detecting chronic pulmonary embolic burden.
Increased vascular resistance due to obstruction of the vascular bed leads to pulmonary hypertension.
Differential considerations on a CTPA include 5:
- perivascular pulmonary edema
- motion: breathing artifact
- flow-related artifact
- streak artifact
- due to incorrect window settings
- misinterpretation of veins as arteries
- pulmonary arterial catheter 5
- intrinsic intraluminal tumor