Falaschi F, Palla A, Battolla L, Paolicchi A, Boraschi P, Bartolozzi C
Cattedra di Radiologia, Università degli Studi di Pisa, Ospedale Santa Chiara.
Radiol Med. 1993 Sep;86(3):227-33.
Pulmonary circulation was evaluated in normal subjects and in post-embolic patients. Eight normal subjects, 3 patients with acute pulmonary embolism and 8 patients with chronic thromboembolic pulmonary hypertension underwent CT of the chest. High-resolution CT and angio-CT were performed to study pulmonary parenchyma and pulmonary arteries, respectively. CT showed thrombi in the main or interlobar pulmonary arteries in all 3 cases of acute pulmonary embolism and in 4 of 8 patients affected with chronic thromboembolic pulmonary hypertension. The diameters of the main pulmonary and right interlobar arteries correlated with systolic pulmonary artery pressure (p < 0.001), as measured by right heart catheterization. In the patients affected with chronic thromboembolic pulmonary hypertension, the ratio of the calibers of the segmental arteries to the corresponding bronchi was markedly higher, which was observed also in the patients with acute pulmonary embolism. The bronchial arteries were dilated in 4 of 8 cases of chronic thromboembolic pulmonary hypertension. Lung density was significantly high in the perihilar compartment in the patients with acute thromboembolic hypertension, but not in normal controls and in the cases of acute pulmonary embolism. In conclusion, CT can help to diagnose pathological pulmonary circulation. Particularly, the ratio of the diameters of the segmental arteries to the corresponding bronchi can be useful to evaluate blood circulation.
对正常受试者和栓塞后患者的肺循环进行了评估。8名正常受试者、3名急性肺栓塞患者和8名慢性血栓栓塞性肺动脉高压患者接受了胸部CT检查。分别进行高分辨率CT和血管CT以研究肺实质和肺动脉。CT显示，在所有3例急性肺栓塞患者以及8例慢性血栓栓塞性肺动脉高压患者中的4例中，主肺动脉或叶间肺动脉存在血栓。通过右心导管测量，主肺动脉和右叶间动脉的直径与肺动脉收缩压相关（p < 0.001）。在慢性血栓栓塞性肺动脉高压患者中，段动脉与相应支气管的管径比明显更高，急性肺栓塞患者中也观察到了这一情况。8例慢性血栓栓塞性肺动脉高压患者中有4例支气管动脉扩张。急性血栓栓塞性高血压患者肺门周围区域的肺密度显著升高，但正常对照者和急性肺栓塞患者中则不然。总之，CT有助于诊断病理性肺循环。特别是，段动脉与相应支气管的直径比可用于评估血液循环。
