This paper reviews the current state of the technique of multislice CT (MSCT) scan and imaging postprocessing of CT pulmonary angiography, as well as the CT features of different pulmonary arterial diseases. Investigations demonstrate that MSCT and CTA are available means to visualize pulmonary artery structures and the anatomic correlation between pulmonary artery and adjacent structures. They are fast, effective and noninvasive methods for diagnosing pulmonary arterial diseases.
Humans ; Hypertension, Pulmonary ; diagnostic imaging ; Lung Diseases ; diagnostic imaging ; Lung Neoplasms ; blood supply ; Pulmonary Artery ; diagnostic imaging ; Pulmonary Embolism ; diagnostic imaging ; Tomography, Spiral Computed

Congenital rubella syndrome is characterized by the triad of deafness, cataract and cardiovascular malformations. The great majority of the cases in the literature have been usually diagnosed in infancy and childhood because of various defects at birth. However, we report a rare case of suspected congenital rubella syndrome in an adult with unilateral pulmonary artery stenosis and late-onset cataract.
Adult ; Cataract ; diagnosis ; diagnostic imaging ; Humans ; Male ; Pulmonary Artery ; diagnostic imaging ; Pulmonary Valve Stenosis ; diagnosis ; diagnostic imaging ; Radiography ; Rubella Syndrome, Congenital ; diagnosis ; diagnostic imaging

Adult ; Anomalous Left Coronary Artery ; Coronary Angiography ; Coronary Vessel Anomalies/diagnostic imaging* ; Heart Arrest/etiology* ; Humans ; Pulmonary Artery/diagnostic imaging*

BACKGROUNDThere is increasing evidence that CT pulmonary arteriography and venography allow a better diagnostic yield for deep vein thrombosis (DVT) in suspected acute pulmonary embolism (PE). The aim was to investigate the value for using such an approach in a multiracial Asian population.

METHODSA total of 135 consecutive subjects with clinically suspected PE in various clinical settings (postoperative in 23 subjects) were referred and evaluated for venous thromboembolism using CT pulmonary arteriography and venography in a tertiary hospital, Malaysia. The distribution of DVT was assessed based on the frequency rate of thrombosis in a particular anatomical region (inferior vena cava, pelvic, femoral and popliteal).

RESULTSIn 130 subjects, excluding 5 subjects having poor images, both DVT and PE were detected in 11.5% (15/130) subjects and DVT alone was detected in 6.9% (9/130) subjects giving a combined rate of venous thromboembolism of 18.4%. A history of malignancy was significantly associated with positive scans, P = 0.02. It was found that left pelvic veins (18.2%) and left femoral veins (19.5%) were more commonly thrombosed in this population.

CONCLUSIONCT pulmonary arteriography and venography is a useful technique in the evaluation of venous thromboembolism in a multi-racial Asian population.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Artery ; diagnostic imaging ; Pulmonary Embolism ; diagnostic imaging ; Pulmonary Veins ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Venous Thromboembolism ; diagnostic imaging ; Venous Thrombosis ; diagnostic imaging

Heart Defects, Congenital/diagnosis* ; Humans ; Hypertension ; MicroRNAs/genetics* ; Pulmonary Arterial Hypertension ; Pulmonary Artery/diagnostic imaging*

Objective To assess the application of high-pitch CT pulmonary angiography (CTPA) at 70 kV tube voltage with 15 ml contrast medium using third-generation dual-source CT. Methods A total of 70 patients with clinically suspected pulmonary embolism were randomly divided into two groups: group A (n=35) underwent CTPA on conventional scanning mode (120 kV,80 ml contrast medium);and group B (n=35) underwent CTPA on high-pitch scanning mode at 70 kV tube voltage with 15 ml contrast medium. The CT values and standard deviations of the main pulmonary artery,apical segment of right upper pulmonary lobe (S1),and posterior basal segment of the right lower pulmonary lobe (S10),anterior thoracic air,and back muscles were measured. The signal to noise ratio (SNR),contrast to noise ratio (CNR),and effective dose (ED) were calculated. The overall image quality was evaluated by two blinded radiologists. The quality image was compared using non-parametric test on two independent samples. The potential differences in CT value,SNR,CNR,and ED were analyzed using the independent sample t-test. Results The CT values of main pulmonary artery [(300.62±77.54)HU vs.(332.80±102.80)HU;t=-1.53,P=0.13],S1 [(361.72±84.92)HU vs. (325.37±87.86)HU;t=1.81,P=0.08],and S10 [(359.54±89.61)HU vs. (318.26±87.19)HU;t=2.00,P=0.05] of right lung were not significantly different between group A and group B. The CNR of S1 (22.81±6.05 vs. 19.80±6.60;t=2.05,P=0.04) and S10 (22.65±6.37 vs. 19.28±6.63;t=2.23,P=0.03) of right lung in group A was significantly higher than in group B. The SNR of main pulmonary artery,S1,and S10 of right lung were not significantly different between group A and B. The subjective diagnostic quality values of group A and B were 1 (1,1) and 1 (1,1),respectively (Z=-0.08,P=0.93). The subjective diagnostic quality values evaluated by two radiologists showed excellent consistency(κ=0.87,P=0.01). The mean ED was 79% lower in group B [(0.92±0.23)mSv] than in group A [(4.33±1.80) mSv] (t=11.72,P=0.00).Conclusion Application of high-pitch mode in CTPA at 70 kV with 15 ml contrast medium using third-generation dual-source CT can remarkably reduce radiation dose without affecting image quality.
Computed Tomography Angiography ; methods ; Humans ; Lung ; diagnostic imaging ; Pulmonary Embolism ; diagnostic imaging ; Radiation Dosage ; Signal-To-Noise Ratio ; Stenosis, Pulmonary Artery ; diagnostic imaging

Objectives: To analyze the reasons of missed diagnosis or misdiagnosis on anomalous origin of left coronary artery from pulmonary artery (ALCAPA) by echocardiography. Methods: This is a retrospective study. Patients with ALCAPA who underwent surgical treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2008 to December 2021 were included. According to the results of preoperative echocardiography and surgical diagnosis, the patients were divided into confirmed group or missed diagnosis/misdiagnosis group. The results of preoperative echocardiography were collected, and the specific echocardiographic signs were analyzed. According to the experience of the doctors, the echocardiographic signs were divided into four types, namely clear displayed, vague/doubtful displayed, no display and no notice, and the display rate of each sign was calculated (display rate=number of clearly displayed cases/total number of cases×100%). By referring the surgical data, we analyzed and recorded the pathological anatomy and pathophysiological characteristics of the patients, and the rate of missed diagnosis/misdiagnosis of echocardiography in patients with different characteristics was compared. Results: A total of 21 patients were enrolled, including 11 males, aged 1.8 (0.8, 12.3) years (range 1 month to 47 years). Except for one patient with anomalous origin of left anterior descending artery, the others were all originated from the main left coronary artery (LCA). There were 13 cases of ALCAPA in infant and children, and 8 cases of adult ALCAPA. There were 15 cases in the confirmed group (diagnostic accuracy was 71.4% (15/21)), and 6 cases in the missed diagnosis/misdiagnosis group (three cases were misdiagnosed as primary endocardial fibroelastosis, two cases were misdiagnosed as coronary-pulmonary artery fistula; and one case was missed diagnosis). The working years of the physicians in the confirmed group were longer than those in the missed diagnosis/misdiagnosed group ((12.8±5.6) years vs. (8.3±4.7) years, P=0.045). In infants with ALCAPA, the detection rate of LCA-pulmonary shunt (8/10 vs. 0, P=0.035) and coronary collateral circulation (7/10 vs. 0, P=0.042) in confirmed group was higher than that in missed diagnosis/misdiagnosed group. In adult ALCAPA patients, the detection rate of LCA-pulmonary artery shunt was higher in confirmed group than that in missed diagnosis/misdiagnosed group (4/5 vs. 0, P=0.021). The missed diagnosis/misdiagnosis rate of adult type was higher than that of infant type (3/8 vs. 3/13, P=0.410). The rate of missed diagnosis/misdiagnosis was higher in patients with abnormal origin of branches than that of abnormal origin of main trunk (1/1 vs. 5/21, P=0.028). The rate of missed diagnosis/misdiagnosis in patients with LCA running between the main and pulmonary arteries was higher than that distant from the main pulmonary artery septum (4/7 vs. 2/14, P=0.064). The rate of missed diagnosis/misdiagnosis in patients with severe pulmonary hypertension was higher than that in patients without severe pulmonary hypertension (2/3 vs. 4/18, P=0.184). The reasons with an echocardiography missed diagnosis/misdiagnosis rate of≥50% included that (1) the proximal segment of LCA ran between the main and pulmonary arteries; (2) abnormal opening of LCA at the right posterior part of the pulmonary artery; (3) abnormal origin of LCA branches; (4) complicated with severe pulmonary hypertension. Conclusions: Echocardiography physicians' knowledge of ALCAPA and diagnostic vigilance are critical to the accuracy of diagnosis. Attention should be paid to the pediatric cases with no obvious precipitating factors of left ventricular enlargement, regardless of whether the left ventricular function is normal or not, the origin of coronary artery should be routinely explored.
Male ; Adult ; Infant ; Child ; Humans ; Bland White Garland Syndrome/diagnostic imaging* ; Pulmonary Artery/diagnostic imaging* ; Retrospective Studies ; Missed Diagnosis ; Hypertension, Pulmonary ; Echocardiography ; Coronary Vessel Anomalies/diagnostic imaging*

BACKGROUNDThe relationship between chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) remains largely unknown. This study aimed to explore the association of COPD with CAD, especially with multi-vessel disease (VD).

METHODSThe data of 354 patients who underwent multi-detector computed tomography (MDCT) for suspected CAD were analyzed. Luminal narrowing was defined as at least one lesion 50% or greater stenosis. The analysis of serum biochemistry profile and spirometry were performed on all eligible patients, and the diagnosis of COPD was defined as the criteria of Global Initiative for Chronic Obstructive Lung Disease.

RESULTSPatients with CAD had a significantly higher complication of COPD than those without CAD (11.8% vs. 3.7%, P < 0.001). Comparing with patients without COPD, those with COPD were more likely to have multi-VD, proportion of smoking and high C-reactive protein (CRP) (P < 0.001). Multivariate Logistic regression analysis revealed that the multi-VD was significantly correlated with COPD (P=0.012) and CRP (P=0.015).

CONCLUSIONSThere was a high complication of COPD in patients with CAD, and COPD may be a critical risk factor for CAD, especially for multi-VD. CAD and COPD were closely associated and the interplay of systemic inflammation might in part explain the relationship between them.

Coronary Artery Disease ; complications ; diagnostic imaging ; metabolism ; Humans ; Pulmonary Disease, Chronic Obstructive ; complications ; diagnostic imaging ; metabolism ; Radiography ; Risk Factors

Aged ; Female ; Humans ; Infant ; Lung Diseases ; diagnostic imaging ; Male ; Pulmonary Artery ; diagnostic imaging ; Tomography, X-Ray Computed

Adolescent ; Female ; Fistula ; diagnosis ; diagnostic imaging ; Heart Atria ; diagnostic imaging ; pathology ; Humans ; Pulmonary Artery ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods