Optimizing the diagnosis and assessment of chronic thromboembolic pulmonary hypertension with advancing imaging modalities

Imaging is key to nearly all aspects of chronic thromboembolic pulmonary hypertension including management for screening, assessing eligibility endarterectomy, and post-operative follow-up. While ventilation/perfusion scintigraphy, the gold standard technique can have excellent sensitivity, it be confounded by other etiologies malperfusion, does not provide structural information guide operability assessment. Conventional computed tomography angiography has high specificity, though findings visually subtle unrecognized. In addition, morphologic aid in pre-operative workup assessment abnormalities. Advances imaging techniques, dual-energy spectral-detector tomography, allow improved sensitivity specificity detecting hypertension, comparable that scans. Furthermore, these advanced compared with conventional additional physiologic data from perfused blood volume maps resolution better visualize distal an important consideration balloon angioplasty inoperable patients. Electrocardiogram-synchronized techniques electrocardiogram-gated also show further regarding right ventricular function structure. care includes a scan, angiography, direct catheter echocardiogram, coronary angiogram, future scan may enable “one-stop” study diagnosis, assessment, treatment decisions less radiation exposure cost than traditional modalities.