Utilidad de la TC dual en el diagnóstico y seguimiento de la Hipertensión Pulmonar Tromboembólica Crónica (HPTEC)
Palabras clave:
Póster, seram, HPTEC, hipertensión pulmonar, tromboembólicaResumen
Objetivos Docentes
• Describir los hallazgos radiológicos en la hipertensión pulmonar tromboembólica crónica (HPTEC) mediante TC dual.
• Describir el rol de la TC dual en el algoritmo diagnóstico, en el tratamiento y seguimiento de la HPTEC.
Revisión del tema
INTRODUCCIÓN
La Hipertensión arterial pulmonar (HAP) es un estado hemodinámico y fisiopatológico que puede ocurrir en múltiples condiciones clínicas y que se define como una presión arterial pulmonar media en reposo ≥ 25 mm Hg medida mediante cateterismo cardíaco derecho. Es una condición rápidamente progresiva y fatal que condiciona fallo ventricular derecho y muerte.
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- Lang IM, Plank C, Sadushi-Kolici R, Jakowitsch J, Klepetko W, Maurer G. Imaging in pulmonary hypertension. JACC Cardiovasc Imaging. 2010 Dec;3(12):1287-95.
- Simonneau G, Robbins IM, Beghetti M, Channick RN, Delcroix M, Denton CP, Elliott CG, Gaine SP, Gladwin MT, Jing ZC, Krowka MJ, Langleben D, Nakanishi N, Souza R. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2009 Jun 30;54(1 Suppl):S43-54.
- Tanabe N, Sugiura T, Tatsumi K. Recent progress in the diagnosis and management of chronic thromboembolic pulmonary hypertension. Respir Investig. 2013 Sep;51(3):134-46.
- Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P; Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004 May
;350(22):2257-64.
- Martí D, Gómez V, Escobar C, Wagner C, Zamarro C, Sánchez D, Sam A, Briongos S, Gaudó J, Sueiro A, Jiménez D. [Incidence of symptomatic and asymptomatic chronic thromboembolic pulmonary hypertension]. Arch Bronconeumol. 2010 Dec;46(12):628-33. 64.
- Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975; 17: 259–270.
- Jenkins D, Mayer E, Screaton N, Madani M. State-of-the-art chronic thromboembolic pulmonary hypertension diagnosis and management. Eur Respir Rev. 2012 Mar 1;21(123):32-9. doi: 10.1183/09059180.00009211. Review.
- Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, Beghetti M, Corris P, Gaine S, Gibbs JS, Gomez-Sanchez MA, Jondeau G, Klepetko W, Opitz C, Peacock A, Rubin L, Zellweger M, Simonneau G; ESC Committee for Practice Guidelines (CPG). Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009 Oct;30(20):2493-537.
- Kim NH, Delcroix M, Jenkins DP, Channick R, Dartevelle P, Jansa P, Lang I, Madani MM, Ogino H, Pengo V, Mayer E. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D92-9.
- Ameli-Renani S, Rahman F, Nair A, Ramsay L, Bacon JL, Weller A, Sokhi HK, Devaraj A, Madden B, Vlahos I. Dual-energy CT for imaging of pulmonary hypertension: challenges and opportunities. Radiographics. 2014 Nov-Dec;34(7):1769-90.
- Castañer E, Gallardo X, Ballesteros E, Andreu M, Pallardó Y, Mata JM, Riera L. CT diagnosis of chronic pulmonary thromboembolism. Radiographics. 2009 Jan-Feb;29(1):31-50; discussion 50-3.
- Kauczor HU, Schwickert HC, Mayer E, Schweden F, Schild HH, Thelen M. Spiral CT of bronchial arteries in chronic thromboembolism. J Comput Assist Tomogr. 1994 Nov-Dec;18(6):855-61.
- Remy-Jardin M, Remy J, Louvegny S, Artaud D, Deschildre F, Duhamel A. Airway changes in chronic pulmonary embolism: CT findings in 33 patients. Radiology.1997 May;203(2):355-60.
- Le Faivre J, Duhamel A, Khung S, Faivre JB, Lamblin N, Remy J, Remy-Jardin M. Impact of CT perfusion imaging on the assessment of peripheral chronic pulmonary thromboembolism: clinical experience in 62 patients. Eur Radiol. 2016 Mar 14.
- Renard B, Remy-Jardin M, Santangelo T, Faivre JB, Tacelli N, Remy J, Duhamel A. Dual-energy CT angiography of chronic thromboembolic disease: can it help recognize links between the severity of pulmonary arterial obstruction and perfusion defects? Eur J Radiol. 2011 Sep;79(3):467-72.
- Pontana F, Remy-Jardin M, Duhamel A, Faivre JB, Wallaert B, Remy J. Lung perfusion with dual-energy multi-detector row CT: can it help recognize ground glass opacities of vascular origin? Acad Radiol. 2010 May;17(5):587-94.
- Hoey ET, Mirsadraee S, Pepke-Zaba J, Jenkins DP, Gopalan D, Screaton NJ. Dual-energy CT angiography for assessment of regional pulmonary perfusion in patients with chronic thromboembolic pulmonary hypertension: initial experience. AJR Am J Roentgenol. 2011 Mar;196(3):524-32. doi:
2214/AJR.10.4842.
- Otrakji A, Digumarthy SR, Lo Gullo R, Flores EJ, Shepard JA, Kalra MK. Dual-Energy CT: Spectrum of Thoracic Abnormalities. Radiographics. 2016 Jan-Feb;36(1):38-52.
- Nakazawa T, Watanabe Y, Hori Y, Kiso K, Higashi M, Itoh T, Naito H. Lung perfused blood volume images with dual-energy computed tomography for chronic thromboembolic pulmonary hypertension: correlation to scintigraphy with single-photon emission computed tomography. J Comput
Assist Tomogr. 2011 Sep-Oct;35(5):590-5.
- Dournes G, Verdier D, Montaudon M, Bullier E, Rivière A, Dromer C, Picard F, Billes MA,Corneloup O, Laurent F, Lederlin M. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide
scintigraphy. Eur Radiol. 2014 Jan;24(1):42-51.
- Ley S, Ley-Zaporozhan J, Pitton MB, Schneider J, Wirth GM, Mayer E, Düber C, Kreitner KF Diagnostic performance of state-of-the-art imaging techniques for morphological assessment of vascular abnormalities in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Eur Radiol.
Mar;22(3):607-16.
- Remy-Jardin M, Faivre JB, Pontana F, Molinari F, Tacelli N, Remy J. Thoracic applications of dual energy. Semin Respir Crit Care Med. 2014 Feb;35(1):64 73.
- Remy-Jardin M, Duhamel A, Deken V, Bouaziz N, Dumont P, Remy J. Systemic collateral supply in patients with chronic thromboembolic and primary pulmonary hypertension: assessment with multi-detector row helical CT angiography. Radiology. 2005 Apr;235(1):274-81.