Purpose: There is considerable literature published on noninvasive contrast
-enhanced techniques to diagnose pulmonary vascular abnormalities, however
little data exists on the safety of contrast injections in patients with el
evated pulmonary arterial pressures. We studied the safety of contrast-enha
nced electron beam computed tomography (EBCT) in 29 patients with severe pu
lmonary hypertension. The mean dose of intravenous contrast used was 124 +/
- 39 cc. Materials and methods: Subjects underwent EBCT using contrast inje
cted at a rate of 2-4 ml/s. All patients were watched closely for at least
15 min post-procedure prior to being released. Patients had Doppler echocar
diograms to estimate pulmonary artery pressure. Right heart catheterization
data was collected for patients in which echocardiographic data was unavai
lable. Results: A total of 29 patients with pulmonary arterial hypertension
were studied. There were 17 patients with primary pulmonary hypertension (
PPH), and 12 patients with secondary forms of pulmonary hypertension. None
of the patients developed complications from their study. Conclusion: There
is a paucity of data on the safety of contrast injections in patients with
severely elevated pulmonary arterial pressures. Contrast-enhanced EBCT was
well-tolerated in our diverse series of patients with severely elevated pu
lmonary arterial pressures. Clinicians concerned about invasive pulmonary a
ngiography should consider contrast-enhanced EBCT as a safe alternative to
angiography.