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Pulmonary hypertension in patients with chronic pulmonary thromboembolism: chest radiograph and CT evaluation before and after surgery

  • Chest Radiology
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Abstract

The purpose of this study was to assess the value of morphometric data on conventional radiography and CT predicting the presence and degree of pulmonary hypertension and to assess the reversibility after surgery. On preoperative X-ray films and CT scans of 50 patients with pulmonary hypertension secondary to chronic thromboembolism, we measured the cardiothoracic ratio, basal diameter, length of cardiac contact to sternum, pulmonary trunk, right and left descending pulmonary artery, and the septum angle. These data were correlated with pulmonary arterial pressure. In 14 X-ray patients and 18 CT patients, with follow-up after surgical thromboendarterectomy the reversibility of these changes was assessed. A dilated pulmonary trunk was the most common abnormality (96% each on X-ray and CT). Pulmonary arteries were dilated on X-ray in 40% (right) and 14% (left), and on CT in 92% (right) and 96% (left). The best correlation with mean arterial pressure was found measuring the pulmonary trunk on CT (r = 0.43, p < 0.01). After surgery, reversibility was most significant for the pulmonary trunk on CT (p < 0.0001). In patients with chronic pulmonary embolism, pulmonary hypertension can best be predicted by assessing the diameter of the pulmonary trunk both on X-ray and CT. No close correlation is present between the extent of any parameter and the level of the pulmonary pressure.

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Authors and Affiliations

  1. Department of Radiology, University Hospital, D-55131, Mainz, Germany

    H. C. Schmidt, H. -U. Kauczor, C. Renner, E. Kirchhoff & M. Thelen

  2. Department of Radiology, University Hospital, D-53127, Bonn, Germany

    H. H. Schild

  3. Department of Cardiothoracic Surgery, University Hospital, D-55131, Mainz, Germany

    S. Iversen

  4. Department of Radiology, University of California San Francisco, San Francisco, CA, USA

    P. Lang

Authors
  1. H. C. Schmidt
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  2. H. -U. Kauczor
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  3. H. H. Schild
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  4. C. Renner
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  5. E. Kirchhoff
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  6. P. Lang
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  7. S. Iversen
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  8. M. Thelen
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Correspondence to: H. C. Schmidt

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Schmidt, H.C., Kauczor, H.U., Schild, H.H. et al. Pulmonary hypertension in patients with chronic pulmonary thromboembolism: chest radiograph and CT evaluation before and after surgery. Eur. Radiol. 6, 817–825 (1996). https://doi.org/10.1007/BF00240678

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  • DOI: https://doi.org/10.1007/BF00240678

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