khree-dimensional contrast-enhanced magnetic resonance angiography in a patient with chronic thromboembolic pulmonary hypertension before and after thromboendarterectomy.

The patient was a 69-year-old man with progressive dyspnea during the previous 5 years and no history of thromboembolic events. By means of spiral CT scanning and multiplanar digital subtraction angiography of the pulmonary arteries, chronic thromboembolic pulmonary hypertension was diagnosed. Mean pulmonary artery pressure and pulmonary vascular resistance were elevated to 46 mm Hg and 890 dyne z s z cm, respectively. The patient underwent successful pulmonary thromboendarterectomy, whereby mean pulmonary artery pressure and pulmonary vascular resistance could be substantially reduced to 20 mm Hg and 237 dyne z s z cm, respectively. Three-dimensional contrast-enhanced MR angiography of the pulmonary vasculature clearly depicted the thromboembolic lobar and segmental artery occlusions and stenoses in both lungs as well as the marked postoperative improvement of pulmonary perfusion (Figure).