Helical CT of Pulmonary Vascular Abnormalities
Himanshu Gupta1,2,
William W. Mayo-Smith1,
Martha B. Mainiero1,
Damian E. Dupuy1 and
Gerald F. Abbott1
1
Brown University School of Medicine, Department of Diagnostic Imaging, Rhode
Island Hospital, 593 Eddy St., Providence, RI 02903.
2
Present address: Department of Radiology, Salem Hospital, 81 Highland Ave.,
Salem, MA 01970.
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Fig. 1. —38-year-old hypoxic woman with pulmonary artery stenosis.
Contrast-enhanced CT scan shows focal stenosis (arrow) of right main
pulmonary artery. Patient had history of maternal in utero exposure to
rubella.
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Fig. 2. —50-year-old asymptomatic man with left pulmonary artery
aneurysm. Contrast-enhanced helical CT scan shows aneurysmal dilatation
(arrow) of left pulmonary artery. Patient had no history of
associated valvular abnormality or lung disease.
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Fig. 3A. —54-year-old woman with pulmonary venous varix who was
referred for percutaneous biopsy of nodule seen on chest radiograph. Scout
radiograph of chest shows nodular mass (arrow) in lower right
lung.
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Fig. 3B. —54-year-old woman with pulmonary venous varix who was
referred for percutaneous biopsy of nodule seen on chest radiograph. Arterial
phase multidetector helical CT scan shows no enhancement of lesion
(arrow) contiguous with left atrium.
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Fig. 3C. —54-year-old woman with pulmonary venous varix who was
referred for percutaneous biopsy of nodule seen on chest radiograph. Venous
phase CT scan obtained at same level as B shows enhancement of varicose
right inferior pulmonary vein (arrow).
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Fig. 4A. —73-year-old woman with anomalous pulmonary venous return.
Detail of frontal chest radiograph shows crescent-shaped opacity
(arrow) in right lower lung.
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Fig. 4B. —73-year-old woman with anomalous pulmonary venous return.
Multidetector helical CT scan shows enhancing enlarged pulmonary vein
(arrow) with anomalous drainage inferiorly into inferior vena
cava.
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Fig. 4C. —73-year-old woman with anomalous pulmonary venous return.
Coronal maximum-intensity-projection image shows blood emptying into inferior
vena cava (arrow).
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Fig. 5A. —54-year-old man with arteriovenous malformation presenting
with hemoptysis. Unenhanced multidetector helical CT scan shows
well-circumscribed lobular opacity with serpentine tail (arrow)
arising from pulmonary artery.
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Fig. 5B. —54-year-old man with arteriovenous malformation presenting
with hemoptysis. Three-dimensional shaded-surface—display image confirms
lobulated arteriovenous malformation (arrow). IV contrast agent is
not required to show these lesions because of intrinsic high contrast between
vessels and lung.
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Fig. 6A. —56-year-old woman with pulmonary sequestration. Chest
radiograph shows opacity (arrow) in left lower lung.
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Fig. 6B. —56-year-old woman with pulmonary sequestration.
Contrast-enhanced CT scan shows blood supply to lesion originating from
descending thoracic aorta (arrow).
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Fig. 6C. —56-year-old woman with pulmonary sequestration. More caudal
(than B) image shows systemic arterial supply extending to sequestered
focus of nonaerated lung (arrow).
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Fig. 7A. —67-year-old woman with pulmonary artery pseudoaneurysm from
Swan-Ganz catheter. Chest radiograph from intensive care unit shows Swan-Ganz
catheter and air-space disease in right lower lung (arrow) from
hemorrhage. Patient was catheterized for cardiac failure and developed
hemoptysis after inflation of catheter balloon.
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Fig. 7B. —67-year-old woman with pulmonary artery pseudoaneurysm from
Swan-Ganz catheter. Chest radiograph obtained 5 months after A shows
new well-circumscribed right lung opacity (arrow).
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Fig. 7C. —67-year-old woman with pulmonary artery pseudoaneurysm from
Swan-Ganz catheter. Contrast-enhanced multidetector helical CT scan shows
round enhancing lesion arising from pulmonary artery (arrow).
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Fig. 7D. —67-year-old woman with pulmonary artery pseudoaneurysm from
Swan-Ganz catheter. Axial maximum-intensity-projection image confirms
pulmonary artery pseudoaneurysm (arrow).
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Fig. 8A. —58-year-old woman with bilateral pulmonary artery emboli.
Multidetector helical CT scan shows filling defects in left and right
pulmonary arteries (arrows) consistent with emboli.
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Fig. 8B. —58-year-old woman with bilateral pulmonary artery emboli.
Coronal maximum-intensity-projection CT image shows peripheral opacity at left
lower lung (arrow) consistent with infarct distal to left interlobar
artery embolus (arrowhead).
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Fig. 9. —58-year-old man with large lung sarcoma. Contrast-enhanced
helical CT scan shows sarcoma invading left superior pulmonary vein
(arrow).
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Copyright © 2002 by the American Roentgen Ray Society.
