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Bronchopulmonary Shunts in Patients with Chronic Thromboembolic Pulmonary Hypertension: Evaluation with Helical CT and MR Imaging

Sebastian Ley1, Karl-Friedrich Kreitner, Iris Morgenstern, Manfred Thelen and Hans-Ulrich Kauczor

1 All authors: Department of Radiology, Langenbeckstr. 1, 55131 Mainz, Germany.



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Fig. 1A. MR flow measurements in 27-year-old healthy male volunteer. Magnitude image of MR flow measurement sequence shows region of interest in left pulmonary artery (arrow).

 


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Fig. 1B. MR flow measurements in 27-year-old healthy male volunteer. This velocity-encoded MR image of flow measurement sequence corresponds to A.

 


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Fig. 1C. MR flow measurements in 27-year-old healthy male volunteer. Magnitude image of MR flow measurement sequence shows region of interest in right pulmonary artery (arrow).

 


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Fig. 1D. MR flow measurements in 27-year-old healthy male volunteer. This velocity-encoded MR image of flow measurement sequence corresponds to C.

 


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Fig. 2. 64-year-old man with chronic thromboembolic pulmonary hypertension. CT angiogram shows thrombotic material in wall of right pulmonary artery (thin arrow) and contrast enhancement in remaining lumen (thick arrow).

 


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Fig. 3. CT angiogram of 52-year-old man with chronic thromboembolic pulmonary hypertension shows three dilated bronchial arteries (arrows). Each individual vessel was followed down to hili for adequate position to measure cross-sectional area using double-threshold of 100-3072 H.

 


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Fig. 4. Scatterplot of shunt volume and cross-sectional area of bronchial arteries shows high correlation between shunt volume, as determined by phase-contrast MR imaging, and cross-sectional area of bronchial arteries, as determined by helical CT. Measuring cross-sectional area of dilated bronchial arteries allows estimation of postoperative increase in pulmonary blood flow.

 

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