Montani et al identified findings on a high resolution CT scan which may indicate that a patient with pulmonary arterial hypetension (PAH) has pulmonary veno-occlusive disease (PVOD). A patient with PVOD may not respond to therapy for PAH, so it is important to identify this subgroup when planning therapy. The authors are from Universite Paris-Sud, Universite Pierre et Marie Curie, and multiple hospitals in Paris.
Findings seen in a high resolution CT scan that are seen more often with PVOD:
(1) nodular centrilobular ground-glass opacities
(2) septal lines
(3) lymph node enlargement
Patietns with PVOD were more likely to have 2 or 3 of these findings. The absence of these findings did not exclude PVOD.
In addition, patients with PAH were more likely to have a pericardial effusion
where:
• PVOD represents only a small percent of patients with clinical pulmonary hypertension. Its pre-test population in practice will be less than that seen in the current study.
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