Claudius Melzig1,2, Fabian Rengier3,4. 1. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland. 2. Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland. 3. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland. fabian.rengier@web.de. 4. Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland. fabian.rengier@web.de.
Abstract
BACKGROUND: Increases in pressure in the pulmonary arteries or pulmonary veins may be the result of a variety of underlying diseases. Noninvasive imaging plays a crucial role not only for identification, but also for differential diagnosis. OBJECTIVES: This article provides a comparative review of the signs of increased pulmonary arterial and pulmonary venous pressure in chest X‑ray and computed tomography (CT). RADIOLOGICAL PROCEDURES: Typical signs of a pulmonary arterial or pulmonary venous pressure increase in chest X‑ray and CT facilitate diagnosis of pulmonary hypertension (e.g., enlargement of central pulmonary arteries) and interstitial or alveolar pulmonary edema (e.g., Kerley lines/thickened interlobular septae or butterfly edema). A basic understanding of imaging findings and underlying pathophysiology helps in establishing the differential diagnosis. CONCLUSIONS: Chest X‑ray and CT are essential for diagnosis of patients with suspected increased pulmonary arterial or pulmonary venous pressure.
BACKGROUND: Increases in pressure in the pulmonary arteries or pulmonary veins may be the result of a variety of underlying diseases. Noninvasive imaging plays a crucial role not only for identification, but also for differential diagnosis. OBJECTIVES: This article provides a comparative review of the signs of increased pulmonary arterial and pulmonary venous pressure in chest X‑ray and computed tomography (CT). RADIOLOGICAL PROCEDURES: Typical signs of a pulmonary arterial or pulmonary venous pressure increase in chest X‑ray and CT facilitate diagnosis of pulmonary hypertension (e.g., enlargement of central pulmonary arteries) and interstitial or alveolar pulmonary edema (e.g., Kerley lines/thickened interlobular septae or butterfly edema). A basic understanding of imaging findings and underlying pathophysiology helps in establishing the differential diagnosis. CONCLUSIONS: Chest X‑ray and CT are essential for diagnosis of patients with suspected increased pulmonary arterial or pulmonary venous pressure.