O papel dos exames de imagem na avaliação da circulação pulmonar

Abstract

O conhecimento sobre a estrutura e a função da circulação pulmonar evoluiu sensivelmente nas últimas décadas. A utilização de exames de imagem não invasivos para a avaliação da anatomia e da função dos vasos pulmonares e do coração ganhou ainda mais importância com o advento de tratamentos até então indisponíveis. Além do auxílio para o diagnóstico, as informações obtidas têm se mostrado fundamentais para o estabelecimento de prognósticos e como parâmetro de sucesso dos tratamentos. A presente revisão discute os diversos métodos que podem ser utilizados para a avaliação da circulação pulmonar por imagens existentes nos dias de hoje, desde técnicas amplamente disponíveis e de relativa baixa complexidade técnica, como a radiografia de tórax, até métodos complexos e promissores, como a tomografia de impedância elétrica

Correlation between Degrees of Pulmonary Hypertension and Findings in Complementary Tests

“…Echocardiography is one of the main tools in the diagnosis of PH and its cardiac complications and is considered a routine follow-up test. 1,15,16 In addition to being able to estimate PASP, the possibility of detecting right ventricular dysfunctions is an important parameter in the stratification of PH severity. In this study, the prevalence of RV dilation was 46% in Group 1 patients and 79% in Group 2 patients.…”

“…CT may also clarify the baseline cause of PH in cases in which abnormalities in the vasculature (Class IV) or pulmonary parenchyma (class III) cause the disease. 16 By associating the severity of PH with test findings (CT, ECG and echocardiography) and functional class, we hope to determine the absence or presence of a relationship between increased PASP and progression of anatomical and functional abnormalities in patients.…”

Pulmonary capillary hemangiomatosis: an uncommon cause of pulmonary hypertension

“…CT scans can show diffuse, ill-defined, centrilobular GGOs and signs consistent with PAH (main pulmonary artery diameter > 3 cm). ( 4 , 5 ) The association of centrilobular GGOs with the findings mentioned above is an important clue for differentiating PCH from classic causes of this GGO pattern, such as viral infections and acute hypersensitivity pneumonitis. PCH and PVOD should be suspected in patients with PAH associated with hemoptysis or hemorrhagic pleural effusion and interstitial lung infiltrates.…”

“…( 3 - 5 ) We would like to report another uncommon cause of PH, pulmonary capillary hemangiomatosis (PCH), and describe the important role of imaging methods in establishing the diagnostic suspicion of this condition.…”

“…Currently, PH is defined as a resting mean pulmonary artery pressure ≥ 25 mmHg, as measured by right heart catheterization. ( 5 , 6 ) …”