J Korean Soc Radiol.  2015 Mar;72(3):193-197. 10.3348/jksr.2015.72.3.193.

Differential Imaging Features of Pulmonary Artery Dissection from Other Intraluminal Diseases of Pulmonary Artery: Two Cases Report

• Park JH
• Shin HW
• Sohn KR
• Lee YG

• KMID: 2161173
• DOI: http://doi.org/10.3348/jksr.2015.72.3.193

Abstract

Pulmonary artery dissection is rarer than other intraluminal diseases of pulmonary artery such as pulmonary thromboembolism or pulmonary artery sarcoma. We report two cases of pulmonary artery dissection mimicking pulmonary artery sarcoma. Computed tomography (CT) showed no enhancement of intrapulmonary arterial lesion or expansion of involved pulmonary artery. Magnetic resonance imaging (MRI) showed low-signal intensity intimal flap on T1- and T2-weighted images. There was no fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)-CT. In this case report, we describe the imaging features of pulmonary artery dissection on CT, MRI, and PET-CT.

MeSH Terms

Magnetic Resonance Imaging
Positron-Emission Tomography
Pulmonary Artery*
Pulmonary Embolism
Sarcoma

Figure

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  Fig. 1 Contrast-enhanced axial CT (A) shows homogenous low density lesion (star) in left main pulmonary artery that occupies the entire lumen of the pulmonary artery. T1- (B) and T2- (C) weighted images show a relatively homogeneous high signal intensity lesion (star), covered by low-signal intensity line (arrow) (case 1).

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  Fig. 2 Non-enhanced axial CT (A) and contrast-enhanced axial CT (B) show no enhancement of left main pulmonary arterial lesion (star). Contrast enhanced coronal CT (C) shows that the lesion (star) extends to left lower lobar artery (arrow). Positron emission tomography-CT (D) shows negative fluorodeoxyglucose (FDG) uptake (star). Calcified right perihilar lymph nodes (open arrow) show mild FDG uptake (case 2).

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  Fig. 3 68-year-old woman patient's gross specimen (A) shows hematoma in the pulmonary artery (arrows). Microscopic examination (hematoxylin and eosin stain, × 20) (B) reveals that the hematoma (star) is located in dissected smooth muscle layer (open arrows). 48-year-old woman patient's hematoxylin and eosin stain (× 20) (C) and elastic stain (× 20) (D) of specimen show that the smooth muscle of the pulmonary artery split into two layers (arrows). A, B. Case 2. C, D. Case 1.

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