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Congress: ECR25
Poster Number: C-21834
Type: Poster: EPOS Radiologist (scientific)
Authorblock: A. Horr, P. Langguth, L-P. Schmill, O. Jansen, S. Aludin; Kiel/DE
Disclosures:
Agreen Horr: Nothing to disclose
Patrick Langguth: Speaker: Philips
Lars-Patrick Schmill: Nothing to disclose
Olav Jansen: Nothing to disclose
Schekeb Aludin: Speaker: Philips
Keywords: Lung, Pulmonary vessels, CT, Contrast agent-intravenous, Diagnostic procedure, Localisation, Embolism / Thrombosis, Ischaemia / Infarction
Purpose Pulmonary infarction (PI) results from severe perfusion disturbance in the context of pulmonary artery embolism (PE). However, it is not necessarily correlated with the severity of the PE concerning thrombus burden and site of occlusion [1, 2]. The dual vascular supply of the lungs, consisting of the pulmonary and bronchial circulation, plays a crucial role in maintaining tissue perfusion despite vascular obstruction [3, 4]. The bronchial circulation exhibits approximately six-fold higher systemic pressure compared to the pulmonary circulation, enabling it...
Read more Methods and materials In this retrospective single-center study, 31 patients who underwent contrast-enhanced SDCT for clinically suspected PE between April 2021 and April 2024 were analyzed. All patients had a confirmed PE on CT imaging and showed evidence of PI. A control group (K-group) of 31 patients without PE or PI was included for comparison. The study was approved by the Ethics Committee of the Christian-Albrechts-University of Kiel (D 567/18, Amendment dated October 7, 2024). All CT examinations were performed using a 128-slice...
Read more Results In the PI group, 440 pulmonary artery emboli (PE) were identified, with an average of 14.2 emboli per patient. The most common emboli were found in the right lower lobe artery (61.29%), the right segmental arteries of segments 9 and 10 (74.19%), and the left segmental artery of segment 8 (70.97%). Notably, no PI occurred in the absence of a subsegmental embolus (SSE), indicating that SSEs are a necessary prerequisite for infarct development. Nevertheless, not all SSEs led to infarction,...
Read more Conclusion This study confirms that subsegmental emboli are a necessary but not sufficient condition for the development of PI. Peripheral iodine concentration is a sensitive marker for detecting perfusion changes and shows a significant decrease from an early stage. The fact that no infarction was detected in the absence of a subsegmental embolus underlines the central role of SSE in the pathophysiology of PI. At the same time, the observation that not every SSE leads to infarction suggests potential protective mechanisms...
Read more References [1]   Dalen JE, Haffajee CI, Alpert JS, et al. Pulmonary embolism, pulmonary hemorrhage and pulmonary infarction. N Engl J Med 1977; 296: 1431–1435. doi:10.1056/NEJM197706232962503[2]   Tsao MS, Schraufnagel D, Wang NS. Pathogenesis of pulmonary infarction. Am J Med 1982; 72: 599–606. doi:10.1016/0002-9343(82)90458-2[3]     BLOOMER WE, HARRISON W. Respiratory function and blood flow in the bronchial artery after ligation of the pulmonary artery. Am J Physiol 1949; 157: 317–328. doi:10.1152/ajplegacy.1949.157.2.317[4]     PUMP KK. The bronchial arteries and their anastomoses in the human lung. Dis...
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