Pulmonary Vein Sign on Computed Tomography Pulmonary Angiography in Proximal and Distal Chronic Thromboembolic Pulmonary Hypertension With Hemodynamic Correlation
Open Access
- 15 March 2023
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Thoracic Imaging
- Vol. 38 (3), 159-164
- https://doi.org/10.1097/rti.0000000000000706
Abstract
Background: Pulmonary vein sign (PVS) indicates abnormal pulmonary venous flow on computed tomography pulmonary angiography (CTPA) is a frequent finding in proximal chronic thromboembolic pulmonary hypertension (CTEPH). PVS’s occurrence in distal CTEPH and correlation to disease severity is unknown. Using right heart catheterization data, we evaluated the relationship between PVS and CTEPH disease distribution and severity. Materials and Method: A total of 93 consecutive CTEPH cases with both CTPA and right heart catheterization were identified in this retrospective multi-institutional study. After excluding 17 cases with suboptimal CTPA, there were 52 proximal and 24 distal CTEPH cases. Blood flow in the major pulmonary veins was graded qualitatively. Subgroup analysis of PVS was performed in 38 proximal CTEPH cases before and after pulmonary endarterectomy. Results: PVS was more frequent in proximal (79%) than distal CTEPH (29%) (PP<0.001) had normal venous flow (mean pulmonary artery pressure 46±11 and 25; pulmonary vascular resistance 9.2±4.3 and 2.6 WU preop and postop, respectively). Conclusion: PVS is a common feature in proximal but infrequent findings in distal CTEPH. PVS does not correlate with hemodynamic severity. PVS resolution was seen in the majority of patients following successful endarterectomy.Keywords
This publication has 16 references indexed in Scilit:
- Clinical Significance of Late Phase of Lung Perfusion Blood Volume (Lung Perfusion Blood Volume) Quantified by Dual-Energy Computed Tomography in Patients With Pulmonary ThromboembolismJournal of Thoracic Imaging, 2017
- The Pathobiology of Chronic Thromboembolic Pulmonary HypertensionAnnals of the American Thoracic Society, 2016
- Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertensionCurrent Opinion in Pulmonary Medicine, 2015
- Pulmonary endarterectomy for distal chronic thromboembolic pulmonary hypertensionThe Journal of Thoracic and Cardiovascular Surgery, 2014
- Pulmonary Edema Predictive Scoring Index (PEPSI), a New Index to Predict Risk of Reperfusion Pulmonary Edema and Improvement of Hemodynamics in Percutaneous Transluminal Pulmonary AngioplastyJACC: Cardiovascular Interventions, 2013
- Pulmonary endarterectomy normalizes interventricular dyssynchrony and right ventricular systolic wall stressJournal of Cardiovascular Magnetic Resonance, 2012
- Time course of restoration of systolic and diastolic right ventricular function after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertensionAmerican Heart Journal, 2011
- Time course of reversed cardiac remodeling after pulmonary endarterectomy in patients with chronic pulmonary thromboembolismEuropean Radiology, 2007
- Pulmonary Microvascular Disease in Chronic Thromboembolic Pulmonary HypertensionProceedings of the American Thoracic Society, 2006
- Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomyThe Journal of Thoracic and Cardiovascular Surgery, 2002