الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 163 |  |  |
| | | from | 163 | | |
Abstract
Pulmonary vascular disease (PVD) is a category of disorders. All affect the blood circulation in the lungs. PVD results in significant morbidity and mortality. Symptoms range widely, with some disorders presenting incidentally on imaging and some with profound symptoms of hypoxia, heart failure or hemoptysis. Diseases that affect the pulmonary vasculature encompass a broad range of conditions including acute and chronic pulmonary thromboembolism, pulmonary hypertension, arteriovenous malformations, vasculitis, malignancy, veno-occlusive disease, pulmonary edema and various congenital abnormalities such as hypoplasia, agenesis, stenosis and pulmonary artery sling, anomalous pulmonary venous drainage, sinus venosus defect, and malposition of the septum primum, abnormal number or course of pulmonary veins . A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The traditional method of diagnosis of congenital heart disease has been conventional angiography. While effectiveness in diagnosis, it is an invasive procedure. Evaluation of right and left sided defects may require both venous and arterial punctures. Recent advances in imaging, multi-detector CT angiography and magnetic resonance angiography provide excellent visualization of pulmonary vasculature and allow assessment of disease location and extent. In addition to the anatomical details, these imaging tests can provide functional assessment of the cardiac structures (such as ejection fraction, right ventricular strain or failure), especially with ECG gating. The accuracy of the MDCT in defining PVD has been well established. The new generations of Multi-Detector CT scanners have created new frontiers and possibilities in vascular imaging. The aim of the current study is to assess the role of MSCT angiography in the evaluation of pulmonary vascular diseases. This study was conducted on 30 patients suspected or diagnosed of having pulmonary arterial or pulmonary venous abnormalities on examination. All participants were subjected to CT angiography of the pulmonary vessels and heart and CT scan. Also, image acquisition, imagereconstruction and image interpretation were done for evaluation the pulmonary vascular diseases. • The congenital pulmonary vascular anomalies cases showed cyanosis, poor feeding, tachypnea, and dyspnea. • Most of congenital pulmonary vascular anomaly’s cases had normal pulmonary vein compared to 20% had either partial or total anomaly venous drainage. • The highest percent of cases had dilated MPA, RPA, LPA (46.7%). 26.7% had either atretic or hypo plastic MPA. 40% had normal RPA, 26.7% had normal LPA. • 60% of congenital pulmonary vascular anomalies cases had VSD, 53.3% had ASD, 33.3% had PDA and 13.3% had Major Aortopulmonary Collateral Arteries )MAPCS(. Rt. Side heart was dilated and hypertrophied in 46.7% while left side was dilated and hypertrophied only in 13.3%. TOF was presented in 20% of cases. • In acquired pulmonary vascular abnormalities cases, 80% of them had dyspnea, 73.3% of them had chest pain with only 20.0% of them had hemoptysis. • Most cases showed normal pulmonary vein compared to abnormal vein. • 80% of acquired pulmonary vascular abnormalities cases represent pulmonary embolism, 33.3% had pulmonary hypertension (one case had both embolism & hypertension). Two thirds of cases had embolism in small branches and one third had embolism in MPA. • 45.5% had either cardiomegaly or atherosclerosis and 18.2% had right ventricular hypertrophy (one case had both cardiomegaly and right ventricular hypertrophy). • In acquired pulmonary vascular abnormalities cases, 26.7% had pulmonary edema and 58.3% of pulmonary embolism cases had consolidation. Half of pulmonary embolism cases had collapse and one third of them had atelectasis.