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Clinical Nuclear Medicine Feb 2021A 75-year-old man presented with dyspnea for more than 2 months, with blood test showing low platelet count and cardiac ultrasound showing severe pulmonary hypertension...
A 75-year-old man presented with dyspnea for more than 2 months, with blood test showing low platelet count and cardiac ultrasound showing severe pulmonary hypertension (>54 mm Hg). A CT pulmonary angiogram showed a filling defect in the pulmonary trunk, right and left pulmonary arteries, raising the possibilities of pulmonary embolism or artery sarcoma. FDG PET/CT was performed for further evaluation and showed low uptake in the pulmonary wall, which supported the diagnosis of pulmonary embolism. Patient was treated with anticoagulants with no changes on repeated CT pulmonary angiogram. Patient underwent surgery, and histopatological examination revealed a pulmonary artery sarcoma.
Topics: Aged; Biological Transport; Fluorodeoxyglucose F18; Humans; Male; Positron Emission Tomography Computed Tomography; Pulmonary Artery; Sarcoma; Vascular Neoplasms
PubMed: 33208613
DOI: 10.1097/RLU.0000000000003376 -
The Journal of Thoracic and... Dec 2022
Topics: Humans; Ships; Pulmonary Artery; Catheterization, Swan-Ganz; Catheters
PubMed: 33642105
DOI: 10.1016/j.jtcvs.2021.02.003 -
Echocardiography (Mount Kisco, N.Y.) Mar 2017Up to 50% patients with Takayasu arteritis have pulmonary artery involvement. Hence, the early identification of pulmonary artery involvement to facilitate prompt...
BACKGROUND
Up to 50% patients with Takayasu arteritis have pulmonary artery involvement. Hence, the early identification of pulmonary artery involvement to facilitate prompt treatment is required.
METHODS
This retrospective study was performed in patients diagnosed with Takayasu arteritis between January 2009 and January 2016. Pulmonary artery involvement was confirmed with computed tomographic pulmonary angiography. Images from transthoracic echocardiography in three windows (suprasternal right pulmonary artery long-axis view, parasternal aortic short-axis view, and subxiphoid view) were documented and analyzed.
RESULTS
A total of 27 patients had Takayasu arteritis and pulmonary artery involvement. Characteristic changes identified by echocardiography included luminal medium-to-high echogenic signals, stenosis, and occlusion, as well as intimal thickening. Left pulmonary artery involvement was revealed in the parasternal aortic short-axis view. Right pulmonary artery involvement was best observed in the suprasternal right pulmonary artery long-axis view, with complementary views from the parasternal aortic short-axis and subxiphoid angles. Pulmonary trunk involvement was not observed in all three windows.
CONCLUSIONS
Transthoracic echocardiography could be a useful noninvasive test to detect pulmonary artery involvement in patients with Takayasu arteritis.
Topics: Adult; Echocardiography; Female; Humans; Male; Pulmonary Artery; Retrospective Studies; Takayasu Arteritis
PubMed: 28139021
DOI: 10.1111/echo.13464 -
Surgical and Radiologic Anatomy : SRA Nov 2020Previous studies have shown a correlation between axial pulmonary trunk diameter (PTD) on chest computed tomography (CT) and pulmonary artery pressure. However, it is...
PURPOSE
Previous studies have shown a correlation between axial pulmonary trunk diameter (PTD) on chest computed tomography (CT) and pulmonary artery pressure. However, it is not known whether the PTD slices measured on chest CT have been recorded during the systolic or diastolic phase. The aim of this study was to demonstrate the variations in PTD during the cardiac cycle by measuring coronary CT angiography (CCTA) images.
METHODS
A retrospective analysis was made of 101 patients who underwent CCTA for coronary artery disease assessment. CCTA images were reconstructed during a full cardiac cycle and measurements were taken of the systolic and diastolic PTD and ascending aorta diameter (AAD) from the same slice by two independent observers.
RESULTS
Inter-observer agreement was excellent (intraclass correlation coefficient = 0.99) for all CT measurements. The mean systolic PTD of all patients was 26.3 ± 3.6 mm and the mean diastolic PTD was 22.8 ± 3.2 mm (p < 0.001). The mean difference between systole and diastole was found to be 3.5 ± 1.2 mm for PTD, 1.2 ± 0.7 mm for AAD, and 0.1 ± 0.04 for the PTD/AAD ratio (p values < 0.001). There was no statistical significance of PTD variations according to gender, age, height, weight, body mass index, and body surface area.
CONCLUSION
When an increased PTD is detected in a chest CT compared to normal limits or a previous CT scan, this may be the result of the variation in PTD due to the cardiac cycle.
Topics: Adult; Age Factors; Aged; Aorta; Biological Variation, Population; Computed Tomography Angiography; Coronary Angiography; Coronary Artery Disease; Diastole; Female; Humans; Hypertension, Pulmonary; Male; Middle Aged; Pulmonary Artery; Retrospective Studies; Sex Factors; Systole
PubMed: 32405785
DOI: 10.1007/s00276-020-02493-9 -
European Journal of Cardio-thoracic... May 2022
Topics: Constriction, Pathologic; Heart Defects, Congenital; Humans; Lung; Pulmonary Artery; Tomography, X-Ray Computed; Trachea; Tracheal Stenosis; Treatment Outcome; Vascular Malformations
PubMed: 35201297
DOI: 10.1093/ejcts/ezac127 -
International Journal of Legal Medicine Nov 2019Pulmonary fat embolism (PFE) is a relevant diagnosis playing a role as a sign of vitality or a cause of death. Its severity is assessed according to histological grading...
PURPOSE
Pulmonary fat embolism (PFE) is a relevant diagnosis playing a role as a sign of vitality or a cause of death. Its severity is assessed according to histological grading systems like that of Falzi. The aim of this study was to determine the utility of unenhanced postmortem computed tomography (PMCT) for PFE diagnosis based on the detection of fat layers.
METHODS
Consecutive cases with PMCT and autopsy were studied retrospectively. The case group consisted of cases with positive PFE, and the control group included cases with negative PFE. Three observers independently assessed PMCT data for fat layers in the pulmonary trunk and the right and left pulmonary artery. For cases with fat layers, autopsy protocols were assessed for the cause of death, relation to trauma, and undertaken resuscitation measures.
RESULTS
Eight hundred thirty cases were included: 366 PFE positive cases (144 of Falzi grade 1, 63 of 1.5, 99 of 2, 28 of 2.5, and 32 of 3) and 464 PFE negative cases. Interrater reliabilities varied between substantial and almost perfect, and discrepancies were solved according to majority. Eighteen cases showed fat layers on PMCT (2 controls-traumatic instantaneous deaths-, 16 PFE positive cases). PMCT showed low sensitivity but high specificity for PFE diagnosis. The layers were located at the same position in the pulmonary trunk directly adjacent to the pulmonary valve distal to the right ventricle.
CONCLUSION
Fat layer on PMCT is a rare finding but relates to PFE diagnosis, especially of severe histological grade. It is to be expected in a typical position within the pulmonary trunk.
Topics: Case-Control Studies; Embolism, Fat; Female; Forensic Pathology; Humans; Male; Middle Aged; Predictive Value of Tests; Pulmonary Artery; Pulmonary Embolism; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 30972495
DOI: 10.1007/s00414-019-02055-8 -
The Journal of Thoracic and... Jun 2021
Topics: Humans; Hypertension, Pulmonary; Pulmonary Arterial Hypertension; Pulmonary Artery
PubMed: 32690412
DOI: 10.1016/j.jtcvs.2020.04.131 -
Interactive Cardiovascular and Thoracic... Nov 2020We aimed to describe the anatomic distribution of periarterial pulmonary sympathetic nerves and to observe the long-term morphometric and functional changes after...
OBJECTIVES
We aimed to describe the anatomic distribution of periarterial pulmonary sympathetic nerves and to observe the long-term morphometric and functional changes after pulmonary artery denervation (PADN), a novel therapy for pulmonary arterial hypertension (PAH).
METHODS
A total of 45 beagles were divided into a sympathetic innervation group (n = 3, 33.3% were females), a PAH group (n = 35, 34.3% were females) and a control group (n = 7, 28.5% were females). The PAH group was randomly divided into no-PADN (n = 7), instant-PADN (n = 7), 1M-PADN (n = 7), 2M-PADN (n = 7) and 3M-PADN (n = 7) subgroups. The sympathetic innervation group was sacrificed to reveal the sympathetic innervation of pulmonary arteries. PAH was induced by injecting dehydromonocrotaline (DHMCT) through the right atrium. The pulmonary capillary wedge pressure, right ventricular systolic pressure, right ventricular mean pressure, pulmonary artery systolic pressure and pulmonary artery mean pressure of each group were continuously measured. The cardiac output was detected to calculate the pulmonary vascular resistance. PAH and control groups were subjected to immunofluorescence assay, sympathetic nerve conduction velocity measurement and transmission electron microscopy.
RESULTS
The no-PADN group had significantly higher PVSP, PVMP, pulmonary artery systolic pressure, pulmonary artery mean pressure and pulmonary vascular resistance but lower cardiac output than those of the control group (P < 0.05). Instant-PADN, 1M-PADN, 2M-PADN and 3M-PADN groups had significantly lower PVSP, PVMP, pulmonary artery systolic pressure, pulmonary artery mean pressure and pulmonary vascular resistance but higher cardiac output than those of the no-PADN group (P < 0.05). Most sympathetic nerves were located within 2.5 mm of the intimae of the bifurcation and proximal trunk, mainly in the left trunk. The diameter and cross-sectional area of myelinated fibres in the PAH group were significantly larger than those of the control group. Sympathetic nerve conduction velocity of the PAH group gradually decreased, and nerve fibres were almost demyelinated 3 months after PADN.
CONCLUSIONS
PADN effectively relieved dehydromonocrotaline-induced canine PAH and decreased sympathetic nerve conduction velocity.
Topics: Animals; Disease Models, Animal; Dogs; Hypertension, Pulmonary; Lung; Monocrotaline; Pulmonary Artery; Sympathectomy; Sympathetic Nervous System; Vascular Resistance
PubMed: 33057705
DOI: 10.1093/icvts/ivaa166 -
Seminars in Thoracic and Cardiovascular... 2021
Topics: Carotid Stenosis; Humans; Pulmonary Artery
PubMed: 33171238
DOI: 10.1053/j.semtcvs.2020.10.010 -
General Thoracic and Cardiovascular... Jan 2023The right B downwards-shifting malformation is rare. This malformation often leads to the following complications: abnormal pulmonary arteries that accompany the...
The right B downwards-shifting malformation is rare. This malformation often leads to the following complications: abnormal pulmonary arteries that accompany the downward-displaced B, and complete fusion of the upper and middle lobes into one lobe, with no horizonal fissure. When performing pulmonary anatomical resection in the right upper or middle lobes in patients with this malformation, careful preoperative planning and surgical technique are required, with which the surgeon should be familiar. Herein, we present the anatomical features necessary for anatomical resection of the right B downwards-shifting malformation based on our technical experiences with anatomic segmentectomy and lobectomy techniques.
Topics: Humans; Pneumonectomy; Lung; Lung Neoplasms; Pulmonary Artery
PubMed: 36301486
DOI: 10.1007/s11748-022-01884-6