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Vascular Disease in Chronic Obstructive Pulmonary Disease

¹ Department of Thoracic Imaging, Hospital Calmette, Lille, France

Correspondence and requests for reprints should be addressed to Martine Remy-Jardin, M.D., Ph.D., Department of Thoracic Imaging, Hospital Calmette, Blvd. Jules Leclercq, 59037 Lille, France. E-mail: mremy-jardin{at}chru-lille.fr

ABSTRACT

Since the introduction of multi–detector row computed tomography (MDCT), most attention has been directed toward the use of this technique to improve the characterization of anatomic changes at the level of the airways and lung parenchyma in patients with chronic obstructive pulmonary disease. The introduction of fast rotation speed and dedicated cardiac reconstruction algorithms exploiting the multislice acquisition scheme of the data has opened new possibilities for thoracic imaging, starting with the possibility to integrate cardiac functional information into a diagnostic CT scan of the chest. Initiated with 16-slice MDCT, this concept of integrating morphology and function has been further simplified with 64-slice CT scanners, thus allowing radiologists to provide vital information in the management of patients with a wide variety of acute or chronic respiratory disorders. Because this CT technology also offers the possibility of generating high-resolution and motion-free images of the coronary arteries, evaluation of the coronary arteries in asymptomatic patients at risk for coronary artery disease during CT examinations of the chest can widen the clinical applications of CT for respiratory patients. More recently, the introduction of dual-source CT and its subsequent ability to apply dual energy to chest imaging has added another area of clinical interest at the level of the pulmonary capillary level. The purpose of this article is to review the potential applications of these technological developments in the population of patients with chronic obstructive pulmonary disease to provide a noninvasive depiction of the cardiovascular abnormalities known to occur in this subset of patients.

Key Words: chronic obstructive pulmonary disease • pulmonary arteries • bronchial arteries • coronary arteries • multi–detector row CT angiography