"As in MDCT with a smaller number of slices, the combination of CTV with CTPA in 64-MDCT results in a small but definite increase in the percentage of patients with the diagnosis of thromboembolic disease." 64-MDCT Pulmonary Angiography and CT Venography in the Diagnosis of Thromboembolic Disease
Nazaroglu H et al.
AJR 2009; 192:654-661 "CTV started 210 seconds after the start of the contrast injection. The region from the popliteal fossa to 3-4 cm proximal to the iliac crest was scanned helically from a caudal to cranial direction." 64-MDCT Pulmonary Angiography and CT Venography in the Diagnosis of Thromboembolic Disease
Nazaroglu H et al.
AJR 2009; 192:654-661 - Pulmonary Artery Pseudoaneurysm: Clinical Presentation
- Hemoptysis (which may be brisk)
- Mass or rounded infiltrate on CXR
- Opacification of hemi-thorax on CXR or CT scan
- Management must be aggressive as 100% mortality with rupture - Pulmonary Artery Pseudoaneurysm: Causes
Vascular abnormality
- Behcet disease
- Marfan syndrome
- Takayasu disease
Other causes
- Septic emboli
- Neoplasm
- Pulmonary Artery Pseudoaneurysm: Causes
Infection
- Mycotic aneurysm (direct extension from necrotizing pneumonia or endovascular seeding from endocarditis)
- Mycobacterial aneurysm (Rasmussen Aneurysm) Trauma
- Improper insertion of Swan Ganz
- Penetrating trauma
- "The daily use of MDCT studies for the evaluation of pulmonary embolic disease or aortic abnormalities can reveal incidental PDAs. Small incidental PDAs can be identified on chest MDCT angiography timed for either the pulmonary arteries or the aorta."
Incidental Finding on MDCT of Patent Ductus Arteriosus: Use of CT and MRI to Assess Clinical Importance
Goitein O et al.
AJR 2005;184:1924-1931
- "Our data showed a suboptimal use of the Wells criteria and subjective overestimation of the probability of PE before ordering of CTA. Although a definitive acceptable PE positivity rate for CTA has not been established, the 10% yield represents overuse of CTA as a screening rather than a diagnostic examination."
CT Angiography in the Evaluation of Acute Pulmonary Embolus
Costantion MM et al.
AJR 2008; 191:471-474
- "More than 80% of deaths from PE occurring in the first 30 minutes, and 90% within the first 2.5 hours of the event."
CT Angiography in the Evaluation of Acute Pulmonary Embolus
Costantion MM et al.
AJR 2008; 191:471-474
- "The patients who survive to be referred for diagnostic evaluation are a very different subset of this population. It has been suggested that the mortality and recurrence rates in this population are likely as low as 5%, even if the patient is not treated ."
CT Angiography in the Evaluation of Acute Pulmonary Embolus
Costantion MM et al.
AJR 2008; 191:471-474
- May-Thurner Syndrome
- AKA iliac vein compression syndrome, iliocaval compression syndrome, or Cockett syndrome
- Caused by compression of the left iliac vein by the right common iliac artery
- Results in leg swelling in the absence of mass or DVT
- Pulmonary Artery Stenosis: Etiology
- Systematic vasculitis
- Behcet disease
- Takayasu arteritis
- Inflammatory disease (TB, histoplasmosis)
- Mycotic Pseudoaneurysm of the Pulmonary Artery
- Right sided endocarditis
- Necrotizing pneumonia
- Syphilis
- Tuberculosis (Rasmussen pseudoaneurysm)
- Pulmonary Artery Aneurysms: Facts
- Rare
- May be congenital or required
- Pulmonary hypertension is common
- Complications are hemoptysis which can lead to rupture and may prove fatal
- Pulmonary Arteriovenous Malformations: Facts
- Congenital in origin
- 60-90% of patients have hereditary hemorrhagic telangiectasia (aka Rendu- Osler-Weber syndrome)
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