Dhruv Patel MBBS, BSc, Presenter: Nothing to Disclose

Katherine L. Downey MBBS, BSc, Abstract Co-Author: Nothing to Disclose

Arjun Nair MBBS, Abstract Co-Author: Nothing to Disclose

Ioannis Vlahos MBBS, Abstract Co-Author: Research grant, Bayer AG Support, Bayer AG Research Consultant, Siemens AG

To explain 1 The concepts of Pulmonary Hypertension and Pulmonary Arterial Hypertension 2 The Clinical issues and limitations of early PAH non-invasive/invasive determination 3 PAH detection by MDCT 4 Aetiology determination in known PAH  5 Therapy planning and monitoring 6 Advanced MDCT - Virtual Angioscopy, Gated MDCT, Dual Energy CT

Case material: International PAH Centre 1 WHO Venice 2003 - Classifications, definitions, aetiology 2 Echo PA calculations/limitations 3 PA size (pressure/flow),limitations-pitfalls: ILD, PS 4 Illustrated Anatomic framework for evaluating known PAH: Central PAs-CTEPH Peripheral PAs (IPAH, HPS, PPH) Cardiac (intra/extracardiac shunts) Parenchyma (mosaicism importance, GGOs, PCH) Venous (PAPVR, Sinus venosus) Bronchials significance Endarterectomy preparation, vasodilator/post-surgical imaging

Early determination of PAH and its aetiology is often complex. MDCT is an invaluable routine tool in this evaluation, complementing other invasive and non-invasive tests. The systematic approach demonstrated here and the panorama of common and unusual aetiologies presented in a structured interpretative fashion assists the reader in diagnosing, stratifying and monitoring patients with PAH. Depicted advanced imaging techniques may be used in select cases to further enhance functional evaluation.

Patel, D, Downey, K, Nair, A, Vlahos, I, Multidetector Row CT (MDCT) in the Evaluation of Pulmonary Arterial Hypertension (PAH): Detection, Evaluation, Planning, and Surveillance.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005705.html