DEMONSTRATION OF CHRONIC RECURRENT PULMONARY EMBOLI WITH SPIRAL CT

Chronic recurrent pulmonary emboli may lead, in rare cases, to progres sive pulmonary arterial hypertension which cannot be treated medically . These patients may be helped by bilateral pulmonary thrombendarterec tomy. The value of spiral CT in the diagnosis of this condition was de monstrated in 31 patients. In 12 patients, thrombi could be shown to b e the cause of the pulmonary arterial hypertension. Indirect criteria were vascular occlusions, changes in calibre and mural irregularities which were shown in varying degrees in all patients. In 22 of 31 patie nts there was non-homogeneity of perfusion with greater opacification of the perfused lung parenchyma. In 11 patients scars related to pleur al surfaces were seen. Typical changes of right heart insufficiency (c ardiomegaly, widened central pulmonary arteries) were shown in all pat ients by CT.