title: Pulmonary Artery Pseudoaneurysms: Clinical Features and CT Findings.
abstract: OBJECTIVE
  The purpose of this study was to analyze the clinical and CT features of pulmonary artery pseudoaneurysms (PAPs).
  
  
  METHODS
  A database search of chest CT examinations performed from January 1, 2000 to December 31, 2014 identified 24 patients with findings consistent with PAPs. A CT finding consistent with a PAP was defined as a focal saccular outpouching of a pulmonary artery. Medical records were reviewed to determine clinical presentations, treatments, and outcomes. CT scans were reviewed by two board-certified fellowship-trained chest radiologists.
  
  
  RESULTS
  A total of 35 PAPs were identified in 24 patients. Hemoptysis and shortness of breath were the most common presenting symptoms. The most commonly identified causes of PAPs were infection (33%), neoplasms (13%), and trauma (17%). Of the 35 PAPs, 29 (83%) were located in segmental or subsegmental pulmonary arteries. A solitary PAP was identified in 20 (83%) patients, and multiple PAPs were identified in three patients with endocarditis and one patient with pulmonary metastases. Only three of 35 (9%) PAPs were associated with a ground-glass halo. Endovascular treatment was successfully performed in 12 patients, and only one patient had immediate recurrent hemoptysis after treatment. PAP was clinically suspected by the referring clinicians in only three patients. Sixteen of the 35 (46%) PAPs were not reported on the initial CT studies.
  
  
  CONCLUSIONS
  PAPs showed a strong predilection for the peripheral pulmonary arteries. Multiplicity of PAPs can be seen in the settings of endocarditis and pulmonary metastatic disease. Most PAPs were not associated with a ground-glass halo. PAPs can be lethal but were often not suspected clinically and were underreported by radiologists.
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Gilman
authors.affiliation: 2 Department of Breast Imaging and Intervention, Spectrum Health, Grand Rapids, MI.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Humphrey
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Salazar
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Amita
authors.initials: A
authors.lastname: Sharma
authors.affiliation: 3 Department of Surgery, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Muniappan
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.
authors.forename: Jo-Anne O
authors.initials: JO
authors.lastname: Shepard
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Boston, MA.|4 Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: hemoptysis; pulmonary artery; pulmonary artery pseudoaneurysm