Pulmonary hypertension: role of computed tomography and magnetic resonance imaging.

ABSTRACT

Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) have a leading role in the diagnosis and evaluation of pulmonary arterial hypertension. Technical aspects, advantages, limitations and potential contraindications will be considered. MDCT has many advantages 1) fast examination, 2) good identification of central and peripheral vessels, 3) good characterization of parenchymal findings, and 4) good evaluation of the heart and mediastinal structures. Limitations are 1) the use of iodinated contrast material, and 2) radiation exposure. MRI allows 1) cardiac morphological and functional studies, and 2) identification of central pulmonary arteries. Limitations are 1) long scanning time, 2) poor definition of peripheral arteries, and 3) impossibility of pulmonary evaluation. MDCT and MRI findings allow 1) quick diagnosis of pulmonary arterial hypertension, 2) differential diagnosis between primary and secondary forms, 3) evaluation of cardiac manifestations, and 4) morphological and functional follow-up studies in surgically treated and untreated patients.