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Acquired peripheral pulmonary artery aneurysms: morphological spectrum of disease and multidetector computed tomography angiography findings—cases series and literature review

  • CHEST RADIOLOGY
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Abstract

Background

Acquired peripheral or intraparenchymal pulmonary artery aneurysms (PPAA) are rare entities but are important to recognize because of the associated morbidity. Hemoptysis is their principal complication and is a potentially fatal condition.

Purpose

To illustrate the causes, multidetector CT angiography (MDCTA) findings and differential diagnosis of acquired PPAA.

Materials and methods

The institutional review boards approved this study. We conducted a retrospective review of the demographic data and the results of clinical and laboratory examinations, and imaging studies of patients managed between January 2012 and January 2017 in two institutions.

Results

A total of 19 patients had acquired PPAA that were detected at MDCTA, 9 patients with normal pulmonary artery pressures and 10 with pulmonary hypertension. Nine patients developed PPAA-related acute symptoms. MDCTA features of PPAA include: a lobulated vascular mass, an indistinct irregular arterial wall, aneurysmal thrombosis or wall calcification, findings of impending rupture including perianeurysmal edema, gas or a soft tissue mass.

Conclusion

PPAA are rare. In our series, endocarditis and pulmonary hypertension are the PPAA leading causes. The treatment modality preferred is embolization, especially as surgery poses a very high risk for patients with severe pulmonary hypertension. Further clarification of the natural history of these rare arterial aneurysms is needed.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, P.O. Monaldi, Via Leonardo Bianchi, 80131, Naples, Italy

    Tullio Valente, Giacomo Sica, Massimo Muto, Giorgio Bocchini & Gaetano Rea

  2. Department of Radiology, The James Cook University Hospital NHS Trust, Marton Road, Middlesbrough, TS4 3BW, UK

    Ahmad Abu-Omar

  3. Department of Radiology and Radiotherapy, University of Campania “Luigi Vanvitelli”, Piazza Miraglia, 80138, Naples, Italy

    Alfredo Clemente & Salvatore Cappabianca

Authors
  1. Tullio Valente
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  2. Ahmad Abu-Omar
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  3. Giacomo Sica
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  4. Alfredo Clemente
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  5. Massimo Muto
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  6. Giorgio Bocchini
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  7. Salvatore Cappabianca
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  8. Gaetano Rea
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All authors have equal contributions on the study concepts, design and data acquisition/analysis/interpretation of the manuscript.

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Correspondence to Tullio Valente.

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The authors declare that there is no conflict of interest and have not any financial relationship with any sponsoring organization.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Valente, T., Abu-Omar, A., Sica, G. et al. Acquired peripheral pulmonary artery aneurysms: morphological spectrum of disease and multidetector computed tomography angiography findings—cases series and literature review. Radiol med 123, 664–675 (2018). https://doi.org/10.1007/s11547-018-0900-9

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  • DOI: https://doi.org/10.1007/s11547-018-0900-9

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