Summary and Conclusion
PH, either primary or secondary, is a significant cause of morbidity and mortality.
Although right heart catheterization is the gold standard for measurement of pulmonary artery pressure, this procedure is not without risk and expense. As a result, noninvasive estimation of MPAP is of particular interest and valuable for identifying the prognosis especially in patients with lung disease; and for planning specific therapy.
The MDCT namely HRCT and CTPA are promising and easily reproducible methods in investigation of PH with good positive predictive value ranging from 82% to 92%. The radiologist must be familiar with the different CT signs of PH especially if we know that the sensitivity and specificity of prediction of PH increases when the different criteria are present at the same time.
The importance of MDCT lies not only in diagnosis of PH but also in detecting the type, causes and complications of PH and according to this, treatment and prognosis are differing significantly.
The causes of PH can be summarized as pulmonary, cardiac, vascular and idiopathic. The pulmonary is the commonest cause of PH with the interstitial lung disease on top of the list and the main radiological investigation is HRCT. For cardiac (the second most common cause) and the vascular causes the main radiological investigation is CTPA.
The main complication of PH is right sided heart failure this also can be predicted if we are familiar with their CT signs.
CT and echocardiography are providing complementary information about regarding PH.
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