MDCT Assessment of Pulmonary Arterial Hypertension

Purpose of Review Pulmonary arterial hypertension (PAH) is usually easily detected on echocardiography but the underlying cause is difficult to determine as there is a long list of causes of PAH. Imaging plays a crucial role in the diagnosis and management of suspected PAH. There is need to identify and classify the underlying cause of PAH according to its pathological mechanism. Purpose of this article is to describe criteria for detection of PAH on Computed tomography pulmonary angiography (CTPA) and simplify the approach to PAH case to find the underlying cause. Recent Findings Clinical classification of PAH based on similar pathological mechanism was made in Second World Symposium on PAH (1998) and was updated during the Fifth World Symposium (2013). CTPA has a central role in the detection of PAH and the underlying cause. Current classification scheme emphasizes the necessity of an early, accurate etiologic diagnosis for a better therapeutic approach. Summary This article reviews the CTPA evaluation in PAH, describing CTPA techniques and a systematic approach according to recent classification of PAH. This article also provides multiple examples along with images of real time cases.