Organized thrombus in pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension; imaging with cone beam computed tomography

Munehiro Sugiyama, Tetsuya Fukuda, Yoshihiro Sanda, Yoshiaki Morita, Masahiro Higashi, Takeshi Ogo, Akihiro Tsuji, Jun Demachi, Norifumi Nakanishi, Hiroaki Naito

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)

Abstract

Purpose: To assess the usefulness of cone-beam CT (CBCT) during pulmonary angiography for the evaluation of organized thrombus at segmental or subsegmental arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods: The segmental and/or subsegmental pulmonary arteries of 13 patients with CTEPH were evaluated by CBCT. We classified representative forms of organized thrombus into 4 types (type 1: webs, type 2: web and slits, type 3: slits, and type 4: narrowing or complete occlusion), and the distribution and frequency of the organized thrombus were evaluated. The relative detectability of these lesions using CBCT was compared with that in contrast-enhanced CT pulmonary angiography (CTPA). Results: Type 1 lesions were most frequently observed in both segmental (30/65 = 46 %) and subsegmental branches (72/156 = 46 %). Type 2 lesions were relatively less frequent than type 1, but subsegmental branches were frequently involved (29/156 = 19 %). Type 3 lesions observed as a thin flap in 9/156 subsegmental branches (6 %). Comparing with CTPA, all 40 lesions in segmental branches were detectable in CTPA, whereas only 62 lesions among 90 lesions (69 %) in subsegmental branches could be observed by CTPA. Conclusion: CBCT is found to be useful for the treatment planning of balloon pulmonary angioplasty distal to segmental arteries.

Original languageEnglish
Pages (from-to)375-382
Number of pages8
JournalJapanese Journal of Radiology
Volume32
Issue number7
DOIs
Publication statusPublished - 2014 Jul
Externally publishedYes

Keywords

  • Chronic thromboembolic pulmonary hypertension
  • Cone beam computed tomography
  • Organized thrombus

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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