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Radiology
Pulmonary Vascular Disease
Built from Fundamentals of Diagnostic Radiology
What’s inside
5 sections · 98 slides
Overview
- The four pulmonary vascular diseases
Pulmonary Edema
How the lung stays dry, how fluid builds up, and the many causes of edema
- How the lung normally stays dry
- The two compartments of pulmonary edema
- Three mechanisms of pulmonary edema
- Starling forces govern lung fluid
- Imaging signs of interstitial edema
- Hydrostatic interstitial pulmonary edema
- What airspace edema looks like
- Thin-section CT in pulmonary edema
- Thin-section CT of hydrostatic interstitial edema
- Hydrostatic edema and venous hypertension
- Four categories of PVH causes
- Causes of pulmonary venous hypertension and pulmonary edema
- The classic PVH radiograph
- Redistribution of pulmonary blood flow
- When redistribution misleads
- Wedge pressure stages of PVH
- How wedge pressure is measured
- Atypical PVH appearances
- Right upper lobe edema in mitral regurgitation
- Right upper lobe edema in severe mitral regurgitation
- Edema in the emphysematous lung
- Increased permeability edema
- Pathogenesis of permeability edema
- Etiologies of increased permeability pulmonary edema
- Three stages of ARDS
- The ARDS radiograph pattern
- Increased permeability edema in ARDS
- Thin-section CT of lung injury edema
- How ARDS changes over time
- Distinguishing the two edemas
- Why the distinction gets hard
- Neurogenic pulmonary edema
- High-altitude pulmonary edema
- Reexpansion pulmonary edema
- Edema from acute upper airway obstruction
- Amniotic fluid embolism
- Fat embolism
- Fat embolism producing permeability edema
Pulmonary Hemorrhage and Vasculitis
Bleeding into the airspaces and the autoimmune vasculitides
- What causes pulmonary hemorrhage
- Causes of pulmonary hemorrhage
- Goodpasture syndrome
- Goodpasture syndrome on chest radiograph
- Goodpasture on CT and over time
- CT of pulmonary hemorrhage
- Idiopathic pulmonary hemorrhage
- Other vasculitides
- ANCA-associated vasculitides
- Recognizing pulmonary hemorrhage
Pulmonary Embolism
Clots and other emboli, and how imaging finds them
- Pulmonary embolism at a glance
- 84%
- PE signs and the D-dimer test
- Imaging options for suspected PE
- Chest radiograph in PE
- PE without infarction on radiograph
- PE with infarction
- Pulmonary infarct from acute pulmonary embolism
- How infarcts resolve
- Limits of the chest radiograph
- V/Q lung scintigraphy
- CT pulmonary angiography
- Acute and chronic emboli on CTPA
- Pulmonary embolism on CT angiography
- Chronic pulmonary emboli
- CTPA pitfalls
- CTPA performance and limits
- Pulmonary angiography
- Imaging for DVT
- Nonthrombotic pulmonary embolism
- Embolized methyl methacrylate after vertebroplasty
- Pulmonary tumor emboli
- Pulmonary tumor emboli from renal cell carcinoma
Pulmonary Arterial Hypertension
High pulmonary artery pressure from increased flow or increased resistance
- Defining pulmonary arterial hypertension
- The PAH chest radiograph
- Pulmonary arterial hypertension on radiograph
- CT measurement in PAH
- Pulmonary arterial hypertension on CT
- Increased flow can enlarge central arteries
- Acquired Eisenmenger syndrome
- Eisenmenger physiology
- Congenital Eisenmenger syndrome
- Two routes to pulmonary arterial hypertension
- Increased resistance as the main cause
- Causes of pulmonary arterial hypertension
- Causes of pulmonary arterial hypertension (continued)
- Parenchymal lung disease and PAH
- Pulmonary arterial hypertension with usual interstitial pneumonia
- Hypoventilation causes of PAH
- Pulmonary artery disorders and CTPH
- Chronic thromboembolic pulmonary hypertension
- Idiopathic pulmonary hypertension
- Pulmonary venoocclusive disease
- Pulmonary venoocclusive disease
- Recognizing PVOD and PCH
- Pulmonary vascular disease: key points
- Suggested readings
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology