CT Pulmonary Angiography > Systematic Approach > 10-Step Approach

Systematic Approach to the Evaluation of the Pulmonary Arteries

This approach can be used to help evaluate the pulmonary arteries in a systematic fashion. Once the approach becomes routine, common patterns of anatomical variants (described above) should be recognized and the system modified to accommodate. Review the segmental anatomy of each lung and the pulmonary arteries below.

Evaluation of the pulmonary arteries is best performed at a workstation, where blood vessels can be more easily followed along their courses. As well, a workstation allows rapid switching between vascular (W 550 / L 150) and lung (W 1400 / L -400) windows, which is necessary to evaluate the spatial relationships of vessels to bronchi.

In the central portions of the lungs, the upper lobe arteries are generally central to their associated bronchi; and the middle and lower lobe and lingular arteries are generally peripheral to their associated bronchi (12). The pulmonary veins are generally anterior to the arteries except in the right upper lobe.

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