Representative coronal preoperative ventilation-perfusion CT and postoperative ventilation-perfusion CT images obtained after pulmonary endarterectomy. (IMAGE)
Caption
Representative coronal preoperative ventilation-perfusion CT (A–C) and postoperative ventilation-perfusion CT (D–F) images obtained after pulmonary endarterectomy in a 64-year-old female patient with chronic thromboembolic pulmonary hypertension. Circles show pathology. (A) CT angiographic image obtained before surgery shows a wall-adherent thrombus in the central right pulmonary artery extending into the upper lobe artery. (C) Perfusion image shows a corresponding lobar defect in the right upper lobe; region of interest (circle) placed in right upper lobe with a normalized iodine uptake of 4%. (B) Ventilation is homogeneous (region of interest in right upper lobe, 0.46) and preserved at normal level, representing a ventilation/perfusion mismatch. After surgical removal of the thrombus (circle in D), the perfusion in the right upper lobe increased (circle in F; from 4% to 13%), and ventilation remained stable within normal range and comparable before (B) and after (E) surgery.
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Radiological Society of North America
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