Characterization of Heart and Pulmonary Vessels in Patients with Pulmonary Hypertension and Embolism using Computed Tomography

Abstract

The study aimed to characterize the heart and pulmonary vessels in patients with PH, PE, and CTEPH using Computed Tomography. Pulmonary embolism PE is a potentially life threatening condition which requires adequate diagnosis. And pulmonary hypertension PH is a complex disorder and may be related to a variety of diseases. It may arise in association with chronic pulmonary thromboembolism CTEPH or pulmonary embolism PE. It is a serious illness that becomes progressively worse and is sometimes fatal. This study was conducted at Royal Care International Hospital and Doctor’s Clinic radiographic departments during the period spanned from 2013-2016 A sample of 55 patients with clinically diagnosed as PE was enrolled, their mean ages were 54.20±14.21years and a sample of 20 patients with PH mean ages were 60.4±13.96 and 25 patients with CTEPH their mean ages were 61.24±9.5 and 50 normal subjects were considered as control group, their mean ages were 50.7±14.5. The sample included both genders. In order to evaluate PE sample the study was directed to investigate whether the presence of plural parenchymal findings correlates with the PE and to know the plural parenchymal abnormalities associated with PE, also to know the correlation of PE with the presence of heart changes and pulmonary vessels measurements. CTPA scans were acquired and there for the clinical signs, pluroparenchymal abnormalities, pulmonary artery tree measurements, right ventricle and atrium diameters, Inter ventricular septum width as well as the myocardium thickening were characterized .The results showed that the PE patients group had dilated measurements than the normal control subjects. The right ventricle diameter changes were found to be significantly related to the presence of PE at p≤0.001. Significant changes at p≤0.005 were also noticed in the pulmonary trunk diameter as well as the right and left main pulmonary arteries with no significant changes detected in the distal portion of both pulmonary arteries diameters. The common complaints from PE patients were chest pain, shortness of breathing, lower limb swelling, tachycardia and syncope. Consolidation, ground glass opacifications, mosaic, right ventricle morphological changes and pleural effusion were present in the majority of patients. For the evaluation of PH and the association with CTEPH and pulmonary embolism PE, this study evaluated the clinical characteristics and the CTA findings. The results showed that in all patients groups, the pulmonary vascular, cardiac segments and lung parenchyma changes were detected and were significantly different from the normal control subjects at p≤0.000. CTPA is considered as the diagnostic modality of choice in characterization of pulmonary vessels, quantifying heart segments and parenchyma changes. CT Imaging was acceptably used in diagnosis, and in defining the cause, in order to assess the feasibility of surgery, monitoring and thera peutic planning.