Role of multi-detector computed tomography in assessment of pulmonary arterial hypertension

ABSTRACT

Pulmonary arterial hypertension [PAH] may be suspected based on the clinical history, physical examination and electrocardiogram findings but imaging is usually central to confirming the diagnosis, establishing a cause and guiding therapy. The diagnostic pathway of PAH involves a variety of complimentary investigations of which computed tomography pulmonary angiography [CTPA] has established a central role both in helping identify an underlying cause for PAH and assessing resulting functional compromise. In particular, CTPA is considered as the gold standard technique for the diagnosis of thromboembolic disease. This article reviews the CTPA evaluation in PAH, describing CTPA techniques, a systematic approach to interpretation and spectrum of key imaging findings: