The image of pulmonary hypertension

For instance, although the current guidelines strongly recommend the use of ventilation/perfusion imaging to exclude chronic thromboembolic pulmonary hypertension, this technique is not always available. At facilities staffed with well-trained radiologists who are familiar with the diagnosis of chronic thromboembolism, CT and magnetic resonance (MR) angiography present potential alternatives to ventilation/perfusion imaging. The ideal situation is that in which the various techniques are available and are used in a complementary manner, experienced hands making optimal use of the strengths of each imaging modality. For instance, when pulmonary hypertension is suspected, ventilation/perfusion imaging is considered the most sensitive tool for the diagnosis of chronic thromboembolic pulmonary hypertension. However, this technique provides no information on the pulmonary vasculature. Therefore, if ventilation/perfusion imaging indicates chronic thromboembolic pulmonary hypertension, additional investigation is required. Although CT angiography provides excellent data on the central pulmonary arteries, it is limited in the detection of small peripheral artery lesions.