Pulmonary Hypertension and Thromboembolic Disease

  • Sebastian LeyEmail author
  • Karl-Friedrich Kreitner
Part of the Medical Radiology book series (MEDRAD)


Pulmonary hypertension (PH) is a disease group that includes a wide variety of entities leading to an increased pulmonary arterial pressure. This chapter describes the basic mechanisms that lead to PH and the possibilities of MRI in diagnosing different aspects. A MR imaging protocol is provided making MRI a comprehensive modality for the classification of the underlying disease and assessment of hemodynamics.


  1. Abolmaali ND, Esmaeili A, Feist P, Ackermann H, Requardt M, Schmidt H, Vogl TJ (2004) Reference values of MRI flow measurements of the pulmonary outflow tract in healthy children. Fortschr Röntgenstr 176(6):837–845CrossRefGoogle Scholar
  2. Abolmaali N, Seitz U, Esmaeili A, Kock M, Radeloff D, Ackermann H, Vogl TJ (2007) Evaluation of a resistance-based model for the quantification of pulmonary arterial hypertension using MR flow measurements. J Magn Reson Imaging 26(3):646–653PubMedCrossRefGoogle Scholar
  3. Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU (2003) Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging 17(3):323–329PubMedCrossRefGoogle Scholar
  4. Altes TA, Eichinger M, Puderbach M (2007) Magnetic resonance imaging of the lung in cystic fibrosis. Proc Am Thorac Soc 4(4):321–327PubMedCrossRefGoogle Scholar
  5. Baile EM, Ling H, Heyworth JR, Hogg JC, Pare PD (1985) Bronchopulmonary anastomotic and noncoronary collateral blood flow in humans during cardiopulmonary bypass. Chest 87(6):749–754PubMedCrossRefGoogle Scholar
  6. Bergin CJ, Hauschildt J, Rios G, Belezzuoli EV, Huynh T, Channick RN (1997) Accuracy of MR angiography compared with radionuclide scanning in identifying the cause of pulmonary arterial hypertension. AJR Am J Roentgenol 168(6):1549–1555PubMedCrossRefGoogle Scholar
  7. Bugnone AN, Viamonte M, Jr., Garcia H (2002) Imaging findings in human immunodeficiency virus-related pulmonary hypertension: report of five cases and review of the literature. Radiology 223(3): 820–827PubMedCrossRefGoogle Scholar
  8. Carvalho P, Anderson DK, Charan NB (2007) Bronchial arterial imaging using helical computed tomography. Pulm Pharmacol Ther 20(2):104–108PubMedCrossRefGoogle Scholar
  9. Caso P, Galderisi M, Cicala S, Cioppa C, D’Andrea A, Lagioia G, Liccardo B, Martiniello AR, Mininni N (2001) Association between myocardial right ventricular relaxation time and pulmonary arterial pressure in chronic obstructive lung disease: analysis by pulsed Doppler tissue imaging. J Am Soc Echocardiogr 14(10):970–977PubMedCrossRefGoogle Scholar
  10. Chaouat A, Naeije R, Weitzenblum E (2008) Pulmonary hypertension in COPD. Eur Respir J 32(5):1371–1385PubMedCrossRefGoogle Scholar
  11. Charalampopoulos A, Gibbs JS, Davies RJ, Gin-Sing W, Murphy K, Sheares KK, Pepke-Zaba J, Jenkins DP, Howard LS (2016) Exercise physiological responses to drug treatments in chronic thromboembolic pulmonary hypertension. J Appl Physiol (1985) 121(3):623–628. doi:10.1152/japplphysiol.00087.2016CrossRefGoogle Scholar
  12. Chatterjee K, De Marco T, Alpert JS (2002) Pulmonary hypertension: hemodynamic diagnosis and management. Arch Intern Med 162(17):1925–1933PubMedCrossRefGoogle Scholar
  13. Cuttica MJ (2016) Pulmonary hypertension associated with lung diseases and hypoxemia. Heart Fail Rev 21(3):299–308. doi:10.1007/s10741-016-9551-xPubMedCrossRefGoogle Scholar
  14. Delcroix M, Kerr K, Fedullo P (2016) Chronic thromboembolic pulmonary hypertension. Epidemiology and risk factors. Ann Am Thorac Soc 13(Suppl 3):S201–S206. doi:10.1513/AnnalsATS.201509-621ASPubMedCrossRefGoogle Scholar
  15. Dellegrottaglie S, Sanz J, Poon M, Viles-Gonzalez JF, Sulica R, Goyenechea M, Macaluso F, Fuster V, Rajagopalan S (2007) Pulmonary hypertension: accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR. Radiology 243(1):63–69PubMedCrossRefGoogle Scholar
  16. Fernandes T, Planquette B, Sanchez O, Morris T (2016) From acute to chronic thromboembolic disease. Ann Am Thorac Soc 13(Suppl 3):S207–S214. doi:10.1513/AnnalsATS.201509-619ASPubMedCrossRefGoogle Scholar
  17. Flume PA, Mogayzel PJ Jr, Robinson KA, Rosenblatt RL, Quittell L, Marshall BC (2010) Cystic fibrosis pulmonary guidelines: pulmonary complications: hemoptysis and pneumothorax. Am J Respir Crit Care Med 182(3):298–306. doi:10.1164/rccm.201002-0157CI182/3/298PubMedCrossRefGoogle Scholar
  18. Freed BH, Collins JD, Francois CJ, Barker AJ, Cuttica MJ, Chesler NC, Markl M, Shah SJ (2016) MR and CT imaging for the evaluation of pulmonary hypertension. JACC Cardiovasc Imaging 9(6):715–732. doi:10.1016/j.jcmg.2015.12.015PubMedPubMedCentralCrossRefGoogle Scholar
  19. Gatehouse PD, Rolf MP, Graves MJ, Hofman MB, Totman J, Werner B, Quest RA, Liu Y, von Spiczak J, Dieringer M, Firmin DN, van Rossum A, Lombardi M, Schwitter J, Schulz-Menger J, Kilner PJ (2010) Flow measurement by cardiovascular magnetic resonance: a multi-centre multi-vendor study of background phase offset errors that can compromise the accuracy of derived regurgitant or shunt flow measurements. J Cardiovasc Magn Reson 12:5PubMedPubMedCentralCrossRefGoogle Scholar
  20. Gopalan D, Blanchard D, Auger WR (2016) Diagnostic evaluation of chronic thromboembolic pulmonary hypertension. Ann Am Thorac Soc 13(Suppl 3):S222–S239. doi:10.1513/AnnalsATS.201509-623ASPubMedCrossRefGoogle Scholar
  21. Green FH, Butt JC, James AL, Carroll NG (2006) Abnormalities of the bronchial arteries in asthma. Chest 130(4):1025–1033PubMedCrossRefGoogle Scholar
  22. Hartmann IJ, Remy-Jardin M, Menchini L, Teisseire A, Khalil C, Remy J (2007) Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography. Eur Radiol 17(8):1943–1953PubMedCrossRefGoogle Scholar
  23. Jardim C, Rochitte CE, Humbert M, Rubenfeld G, Jasinowodolinski D, Carvalho CR, Souza R (2007) Pulmonary artery distensibility in pulmonary arterial hypertension: an MRI pilot study. Eur Respir J 29(3):476–481PubMedCrossRefGoogle Scholar
  24. Jenkins DP, Biederman A, D’Armini AM, Dartevelle PG, Gan HL, Klepetko W, Lindner J, Mayer E, Madani MM (2016) Operability assessment in CTEPH: lessons from the CHEST-1 study. J Thorac Cardiovasc Surg. doi:10.1016/j.jtcvs.2016.02.062PubMedCrossRefGoogle Scholar
  25. Jobst BJ, Wielputz MO, Triphan SM, Anjorin A, Ley-Zaporozhan J, Kauczor HU, Biederer J, Ley S, Sedlaczek O (2015) Morpho-functional 1H-MRI of the lung in COPD: short-term test-retest reliability. PLoS One 10(9):e0137282. doi:10.1371/journal.pone.0137282PubMedPubMedCentralCrossRefGoogle Scholar
  26. Jung JI, Park SH, Lee JM, Hahn ST, Kim KA (2000) MR characteristics of progressive massive fibrosis. J Thorac Imaging 15(2):144–150PubMedCrossRefGoogle Scholar
  27. Kauczor H-U, Cagil H, Fischer B, Schickert HC, Mildenberger P (1994a) CT-Angiographie der Bronchialarterien. Fortschr Röntgenstr 160(5):477–479CrossRefGoogle Scholar
  28. Kauczor H-U, Schwickert HC, Mayer E, Schweden F, Schild HH, Thelen M (1994b) Spiral CT of bronchial arteries in chronic thromboembolism. J Comput Assist Tomogr 18(6):855–861PubMedCrossRefGoogle Scholar
  29. Kluge A, Gerriets T, Lange U, Bachmann G (2005) MRI for short-term follow-up of acute pulmonary embolism. Assessment of thrombus appearance and pulmonary perfusion: a feasibility study. Eur Radiol 15(9):1969–1977PubMedCrossRefGoogle Scholar
  30. Kreitner KF (2014) Noninvasive imaging of pulmonary hypertension. Semin Respir Crit Care Med 35(1):99–111. doi:10.1055/s-0033-1363456PubMedCrossRefGoogle Scholar
  31. Kreitner KF, Ley S, Kauczor HU, Mayer E, Kramm T, Pitton MB, Krummenauer F, Thelen M (2004) Chronic thromboembolic pulmonary hypertension: pre- and postoperative assessment with breath-hold MR imaging techniques. Radiology 232(2):535–543PubMedCrossRefGoogle Scholar
  32. Kreitner KF, Kunz RP, Ley S, Oberholzer K, Neeb D, Gast KK, Heussel CP, Eberle B, Mayer E, Kauczor HU, Duber C (2007) Chronic thromboembolic pulmonary hypertension—assessment by magnetic resonance imaging. Eur Radiol 17(1):11–21PubMedCrossRefGoogle Scholar
  33. Kreitner KF, Wirth GM, Krummenauer F, Weber S, Pitton MB, Schneider J, Mayer E, Dueber C (2013) Noninvasive assessment of pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension by high temporal resolution phase-contrast MRI: correlation with simultaneous invasive pressure recordings. Circ Cardiovasc Imaging 6(5):722–729. doi:10.1161/CIRCIMAGING.112.000276PubMedCrossRefGoogle Scholar
  34. Kunz RP, Oellig F, Krummenauer F, Oberholzer K, Romaneehsen B, Vomweg TW, Horstick G, Hayes C, Thelen M, Kreitner KF (2005) Assessment of left ventricular function by breath-hold cine MR imaging: comparison of different steady-state free precession sequences. J Magn Reson Imaging 21(2):140–148PubMedCrossRefGoogle Scholar
  35. Kuriyama K, Gamsu G, Stern RG (1984) CT-determined pulmonary artery diameters in predicting pulmonary hypertension. Invest Radiol 19(1): 16–22PubMedCrossRefGoogle Scholar
  36. Laffon E, Laurent F, Bernard V, De Boucaud L, Ducassou D, Marthan R (2001) Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method. J Appl Physiol 90(6):2197–2202PubMedCrossRefGoogle Scholar
  37. Lang I (2015) Chronic thromboembolic pulmonary hypertension: a distinct disease entity. Eur Respir Rev 24(136):246–252. doi:10.1183/16000617.00001115PubMedCrossRefGoogle Scholar
  38. Ley S (2015) Imaging pulmonary arterial thromboembolism: challenges and opportunities. Magn Reson Imaging Clin N Am 23(2):261–271. doi:10.1016/j.mric.2015.01.013PubMedCrossRefGoogle Scholar
  39. Ley S, Kauczor HU (2008) MR imaging/magnetic resonance angiography of the pulmonary arteries and pulmonary thromboembolic disease. Magn Reson Imaging Clin N Am 16(2):263. -273PubMedCrossRefGoogle Scholar
  40. Ley S, Kreitner K-F, Morgenstern I, Thelen M, Kauczor H-U (2002) Bronchopulmonary shunts in patients with chronic thromboembolic pulmonary hypertension: evaluation by helical CT and MR imaging. AJR Am J Roentgenol 179:1209–1215PubMedCrossRefGoogle Scholar
  41. Ley S, Fink C, Zaporozhan J, Borst MM, Meyer FJ, Puderbach M, Eichinger M, Plathow C, Grunig E, Kreitner KF, Kauczor HU (2005) Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results. Eur Radiol 15(11):2256–2263PubMedCrossRefGoogle Scholar
  42. Ley S, Mereles D, Risse F, Grunig E, Ley-Zaporozhan J, Tecer Z, Puderbach M, Fink C, Kauczor HU (2007a) Quantitative 3D pulmonary MR-perfusion in patients with pulmonary arterial hypertension: correlation with invasive pressure measurements. Eur J Radiol 61(2):251–255PubMedCrossRefGoogle Scholar
  43. Ley S, Mereles D, Puderbach M, Gruenig E, Schock H, Eichinger M, Ley-Zaporozhan J, Fink C, Kauczor HU (2007b) Value of MR phase-contrast flow measurements for functional assessment of pulmonary arterial hypertension. Eur Radiol 17(7):1892–1897PubMedCrossRefGoogle Scholar
  44. Ley S, Unterhinninghofen R, Ley-Zaporozhan J, Schenk JP, Kauczor HU, Szabo G (2008) Validation of MR phase-contrast flow measurements in the main pulmonary artery and aorta using perivascular ultrasound in a large animal model. Investig Radiol 43(6):421–426CrossRefGoogle Scholar
  45. Ley-Zaporozhan J, Ley S, Kauczor HU (2007) Proton MRI in COPD. COPD 4(1):55–65PubMedCrossRefGoogle Scholar
  46. Ley-Zaporozhan J, Ley S, Kauczor HU (2008) Morphological and functional imaging in COPD with CT and MRI: present and future. Eur Radiol 18(3):510–521PubMedCrossRefGoogle Scholar
  47. Ley-Zaporozhan J, Ley S, Eberhardt R, Kauczor HU, Heussel CP (2010) Visualization of morphological parenchymal changes in emphysema: comparison of different MRI sequences to 3D-HRCT. Eur J Radiol 73(1):43–49PubMedPubMedCentralCrossRefGoogle Scholar
  48. McLaughlin VV, Shah SJ, Souza R, Humbert M (2015) Management of pulmonary arterial hypertension. J Am Coll Cardiol 65(18):1976–1997. doi:10.1016/j.jacc.2015.03.540PubMedCrossRefGoogle Scholar
  49. McNeil K, Dunning J (2007) Chronic thromboembolic pulmonary hypertension (CTEPH). Heart 93(9):1152–1158PubMedPubMedCentralCrossRefGoogle Scholar
  50. Moses DA, Axel L (2004) Quantification of the curvature and shape of the interventricular septum. Magn Reson Med 52(1):154–163PubMedCrossRefGoogle Scholar
  51. Nael K, Fenchel M, Krishnam M, Finn JP, Laub G, Ruehm SG (2007) 3.0 tesla high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) of the pulmonary circulation: initial experience with a 32-channel phased array coil using a high relaxivity contrast agent. Investig Radiol 42(6):392–398CrossRefGoogle Scholar
  52. Nagendran J, Michelakis E (2007) MRI: one-stop shop for the comprehensive assessment of pulmonary arterial hypertension? Chest 132(1):2–5PubMedCrossRefGoogle Scholar
  53. Nikolaou K, Schoenberg SO, Attenberger U, Scheidler J, Dietrich O, Kuehn B, Rosa F, Huber A, Leuchte H, Baumgartner R, Behr J, Reiser MF (2005) Pulmonary arterial hypertension: diagnosis with fast perfusion MR imaging and high-spatial-resolution MR angiography--preliminary experience. Radiology 236(2):694–703PubMedCrossRefGoogle Scholar
  54. Oberholzer K, Romaneehsen B, Kunz P, Kramm T, Thelen M, Kreitner KF (2004) Contrast-enhanced 3D MR angiography of the pulmonary arteries with integrated parallel acquisition technique (iPAT) in patients with chronic-thromboembolic pulmonary hypertension CTEPH – sagittal or coronal acquisition? Fortschr Röntgenstr Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 176(4):605–609CrossRefGoogle Scholar
  55. Ohno Y, Hatabu H, Murase K, Higashino T, Kawamitsu H, Watanabe H, Takenaka D, Fujii M, Sugimura K (2004) Quantitative assessment of regional pulmonary perfusion in the entire lung using three-dimensional ultrafast dynamic contrast-enhanced magnetic resonance imaging: preliminary experience in 40 subjects. J Magn Reson Imaging 20(3):353–365PubMedPubMedCentralCrossRefGoogle Scholar
  56. Ohno Y, Hatabu H, Murase K, Higashino T, Nogami M, Yoshikawa T, Sugimura K (2007) Primary pulmonary hypertension: 3D dynamic perfusion MRI for quantitative analysis of regional pulmonary perfusion. AJR Am J Roentgenol 188(1):48–56PubMedCrossRefGoogle Scholar
  57. Pattynama PMT, Lamb HJ, van der Velde EA, van der Geest RJ, van der Wall EE, de Roos A (1995) Reproducibilty of MRI-derived measurements of right ventricular volumes and myocardial mass. J Magn Reson Imaging 13(1):53–63CrossRefGoogle Scholar
  58. Peacock A, Simonneau G, Rubin L (2006) Controversies, uncertainties and future research on the treatment of chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc 3(7):608–614PubMedCrossRefGoogle Scholar
  59. Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350(22):2257–2264PubMedCrossRefGoogle Scholar
  60. Perloff JK, Hart EM, Greaves SM, Miner PD, Child JS (2003) Proximal pulmonary arterial and intrapulmonary radiologic features of Eisenmenger syndrome and primary pulmonary hypertension. Am J Cardiol 92(2):182–187PubMedCrossRefGoogle Scholar
  61. de Perrot M (2016) Operability assessment in chronic thromboembolic pulmonary hypertension (CTEPH): don’t miss the chance of a second opinion! J Thorac Cardiovasc Surg. doi:10.1016/j.jtcvs.2016.05.049PubMedCrossRefGoogle Scholar
  62. Presberg KW, Dincer HE (2003) Pathophysiology of pulmonary hypertension due to lung disease. Curr Opin Pulm Med 9(2):131–138PubMedCrossRefGoogle Scholar
  63. Primack SL, Mayo JR, Hartman TE, Miller RR, Muller NL (1994) MRI of infiltrative lung disease: comparison with pathologic findings. J Comput Assist Tomogr 18(2):233–238PubMedCrossRefGoogle Scholar
  64. Rajaram S, Swift AJ, Telfer A, Hurdman J, Marshall H, Lorenz E, Capener D, Davies C, Hill C, Elliot C, Condliffe R, Wild JM, Kiely DG (2013) 3D contrast-enhanced lung perfusion MRI is an effective screening tool for chronic thromboembolic pulmonary hypertension: results from the ASPIRE registry. Thorax 68(7):677–678. doi:10.1136/thoraxjnl-2012-203020PubMedCrossRefGoogle Scholar
  65. Reesink HJ, Marcus JT, Tulevski II, Jamieson S, Kloek JJ, Vonk Noordegraaf A, Bresser P (2007) Reverse right ventricular remodeling after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: utility of magnetic resonance imaging to demonstrate restoration of the right ventricle. J Thorac Cardiovasc Surg 133(1):58–64PubMedCrossRefGoogle Scholar
  66. Reiter G, Reiter U, Kovacs G, Olschewski H, Fuchsjager M (2015) Blood flow vortices along the main pulmonary artery measured with MR imaging for diagnosis of pulmonary hypertension. Radiology 275(1):71–79. doi:10.1148/radiol.14140849PubMedCrossRefGoogle Scholar
  67. Reiter U, Reiter G, Fuchsjager M (2016) MR phase-contrast imaging in pulmonary hypertension. Br J Radiol 89(1063):20150995. doi:10.1259/bjr.20150995PubMedPubMedCentralCrossRefGoogle Scholar
  68. Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J (2004) Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 233(3):741–749PubMedCrossRefGoogle Scholar
  69. Remy-Jardin M, Pistolesi M, Goodman LR, Gefter WB, Gottschalk A, Mayo JR, Sostman HD (2007) Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner society. Radiology 245(2):315–329PubMedCrossRefGoogle Scholar
  70. Robertson HT, Jindal SK, Lakshminarayan S, Albert R, Kirk W, Hlastala MP, Butler J (1984) Gas exchange properties of the bronchial circulation in a dog lobe maintained in zone 1 conditions. Am Rev Respir Dis 129(4):A229Google Scholar
  71. Roeleveld RJ, Marcus JT, Faes TJ, Gan TJ, Boonstra A, Postmus PE, Vonk-Noordegraaf A (2005) Interventricular septal configuration at mr imaging and pulmonary arterial pressure in pulmonary hypertension. Radiology 234(3):710–717PubMedCrossRefGoogle Scholar
  72. Rosenkranz S (2007) Pulmonary hypertension: current diagnosis and treatment. Clin Res Cardiol 96(8):527–541CrossRefGoogle Scholar
  73. Ryu JH, Krowka MJ, Pellikka PA, Swanson KL, McGoon MD (2007) Pulmonary hypertension in patients with interstitial lung diseases. Mayo Clin Proc 82(3):342–350PubMedCrossRefGoogle Scholar
  74. Sanz J, Kuschnir P, Rius T, Salguero R, Sulica R, Einstein AJ, Dellegrottaglie S, Fuster V, Rajagopalan S, Poon M (2007) Pulmonary arterial hypertension: noninvasive detection with phase-contrast MR imaging. Radiology 243(1):70–79PubMedCrossRefGoogle Scholar
  75. Sanz J, Kariisa M, Dellegrottaglie S, Prat-Gonzalez S, Garcia MJ, Fuster V, Rajagopalan S (2009) Evaluation of pulmonary artery stiffness in pulmonary hypertension with cardiac magnetic resonance. JACC Cardiovasc Imaging 2(3):286–295PubMedCrossRefGoogle Scholar
  76. Schafer M, Kheyfets VO, Schroeder JD, Dunning J, Shandas R, Buckner JK, Browning J, Hertzberg J, Hunter KS, Fenster BE (2016) Main pulmonary arterial wall shear stress correlates with invasive hemodynamics and stiffness in pulmonary hypertension. Pulm Circ 6(1):37–45. doi:10.1086/685024PC2013254PubMedPubMedCentralCrossRefGoogle Scholar
  77. Schoenfeld C, Cebotari S, Hinrichs J, Renne J, Kaireit T, Olsson KM, Voskrebenzev A, Gutberlet M, Hoeper MM, Welte T, Haverich A, Wacker F, Vogel-Claussen J (2016) MR imaging-derived regional pulmonary parenchymal perfusion and cardiac function for monitoring patients with chronic thromboembolic pulmonary hypertension before and after pulmonary Endarterectomy. Radiology 279(3):925–934. doi:10.1148/radiol.2015150765PubMedCrossRefGoogle Scholar
  78. Shimoda LA, Sham JS, Sylvester JT (2000) Altered pulmonary vasoreactivity in the chronically hypoxic lung. Physiol Res 49(5):549–560PubMedGoogle Scholar
  79. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, Gomez Sanchez MA, Krishna Kumar R, Landzberg M, Machado RF, Olschewski H, Robbins IM, Souza R (2013) Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 62(25 Suppl):D34–D41. doi:10.1016/j.jacc.2013.10.029PubMedCrossRefGoogle Scholar
  80. Sopko DR, Smith TP (2011) Bronchial artery embolization for hemoptysis. Semin Interv Radiol 28(1):48–62. doi:10.1055/s-0031-1273940CrossRefGoogle Scholar
  81. Stricker H (2016) Chronic thromboembolic pulmonary hypertension--a diagnostic and therapeutic update. VASA Zeitschrift fur Gefasskrankheiten 45(3):195–199. doi:10.1024/0301-1526/a000525PubMedCrossRefGoogle Scholar
  82. Swift AJ, Rajaram S, Hurdman J, Hill C, Davies C, Sproson TW, Morton AC, Capener D, Elliot C, Condliffe R, Wild JM, Kiely DG (2013) Noninvasive estimation of PA pressure, flow, and resistance with CMR imaging: derivation and prospective validation study from the ASPIRE registry. JACC Cardiovasc Imaging 6(10):1036–1047. doi:10.1016/j.jcmg.2013.01.013PubMedCrossRefGoogle Scholar
  83. Swift AJ, Wild JM, Nagle SK, Roldan-Alzate A, Francois CJ, Fain S, Johnson K, Capener D, van Beek EJ, Kiely DG, Wang K, Schiebler ML (2014a) Quantitative magnetic resonance imaging of pulmonary hypertension: a practical approach to the current state of the art. J Thorac Imaging 29(2):68–79. doi:10.1097/RTI.0000000000000079PubMedPubMedCentralCrossRefGoogle Scholar
  84. Swift AJ, Telfer A, Rajaram S, Condliffe R, Marshall H, Capener D, Hurdman J, Elliot C, Kiely DG, Wild JM (2014b) Dynamic contrast-enhanced magnetic resonance imaging in patients with pulmonary arterial hypertension. Pulm Circ 4(1):61–70. doi:10.1086/674882PubMedPubMedCentralCrossRefGoogle Scholar
  85. Taichman DB, Mandel J (2007) Epidemiology of pulmonary arterial hypertension. Clin Chest Med 28(1):1–22. viiPubMedCrossRefGoogle Scholar
  86. Thabut G, Dauriat G, Stern JB, Logeart D, Levy A, Marrash-Chahla R, Mal H (2005) Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest 127(5):1531–1536. doi:10.1378/chest.127.5.1531CrossRefGoogle Scholar
  87. Tuder RM, Marecki JC, Richter A, Fijalkowska I, Flores S (2007) Pathology of pulmonary hypertension. Clin Chest Med 28(1):23–42, viiPubMedPubMedCentralCrossRefGoogle Scholar
  88. Wartski M, Collignon MA (2000) Incomplete recovery of lung perfusion after 3 months in patients with acute pulmonary embolism treated with antithrombotic agents. THESEE study group. Tinzaparin ou heparin standard: evaluation dans l’Embolie Pulmonaire study. J Nucl Med 41(6):1043–1048PubMedGoogle Scholar
  89. Wirth G, Bruggemann K, Bostel T, Mayer E, Duber C, Kreitner KF (2014) Chronic thromboembolic pulmonary hypertension (CTEPH) – potential role of multidetector-row CT (MD-CT) and MR imaging in the diagnosis and differential diagnosis of the disease. Rofo 186(8):751–761. doi:10.1055/s-0034-1366425PubMedCrossRefGoogle Scholar
  90. Wright JL, Levy RD, Churg A (2005) Pulmonary hypertension in chronic obstructive pulmonary disease: current theories of pathogenesis and their implications for treatment. Thorax 60(7):605–609PubMedPubMedCentralCrossRefGoogle Scholar

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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Chirurgisches Klinikum München SüdDiagnostic and Interventional RadiologyMunichGermany
  2. 2.Institute of Clinical RadiologyLudwig-Maximilians University Hospital MunichMunichGermany
  3. 3.Department Diagnostic and Interventional RadiologyJohannes Gutenberg-University MainzMainzGermany

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