Diagnostic performance of state-of-the-art imaging techniques for morphological assessment of vascular abnormalities in patients with chronic thromboembolic pulmonary hypertension (CTEPH)

• Verfasst von: Ley, Sebastian [VerfasserIn]
• Verfasst von: Ley-Zaporozhan, Julia [VerfasserIn]
• Titel: Diagnostic performance of state-of-the-art imaging techniques for morphological assessment of vascular abnormalities in patients with chronic thromboembolic pulmonary hypertension (CTEPH)
• Verf.angabe: Sebastian Ley, Julia Ley-Zaporozhan, Michael B. Pitton, Jens Schneider, Gesine M. Wirth, Eckhard Mayer, Christoph Düber, Karl-Friedrich Kreitner
• Jahr: 2012
• Jahr des Originals: 2011
• Umfang: 10 S.
• Teil: volume:22
• Teil: year:2012
• Teil: number:3
• Teil: pages:607-616
• Teil: extent:10
• Fussnoten: First online: 27 September 2011 ; Gesehen am 06.09.2018
• Titel Quelle: Enthalten in: European radiology
• Ort Quelle: Berlin : Springer, 1991
• Jahr Quelle: 2012
• Band/Heft Quelle: 22(2012), 3, Seite 607-616
• ISSN Quelle: 1432-1084
• ISSN Quelle: 1613-3757
• DOI: doi:10.1007/s00330-011-2290-4
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1580748910

Abstract

Objectives: To determine the most comprehensive imaging technique for the assessment of pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: 24 patients with CTEPH were examined by ECG-gated multi-detector CT angiography (MD-CTA), contrast-enhanced MR angiography (ce-MRA) and selective digital subtraction angiography (DSA) within 3 days. Two readers in consensus separately evaluated each imaging technique (48 main, 144 lobar and 449 segmental arteries) for typical changes like complete obstructions, vessel cut-offs, intimal irregularities, incorporated thrombus formations, and bands and webs. A joint interpretation of all three techniques served as a reference standard. Results: Based on image quality, there was no non-diagnostic examination by either imaging technique. DSA did not sufficiently display 1 main, 3 lobar and 4 segmental arteries. The pulmonary trunk was not assessable by DSA. One patient showed thrombotic material at this level only by MD-CTA and MRA. Sensitivity and specificity of MD-CTA regarding CTEPH-related changes at the main/lobar and at the segmental levels were 100%/100% and 100%/99%, of ce-MRA 83.1%/98.6% and 87.7%/98.1%, and of DSA 65.7%/100% and 75.8%/100%, respectively. Conclusion: ECG-gated MD-CTA proved the most adequate technique for assessment of the pulmonary arteries in the diagnostic work-up of CTEPH patients.