■单光子发射计算机断层扫描(SPECT)通气灌注成像是诊断肺栓塞的主要成像方法,在慢性血栓栓塞性肺动脉高压(CTEPH)的诊断和疗效评价中的应用越来越受到重视。近年来,随着计算机软件技术的发展,通气/灌注(V/Q)成像定量分析技术日趋成熟。这项研究的目的是研究肺V/Q闪烁显像定量分析在评估CTEPH患者球囊肺血管成形术(BPA)疗效中的实用性。
■在此回顾性分析中,我们收集了2018年4月至2020年9月在中日友好医院接受BPA治疗的CTEPH患者的数据.样本由23名男性和28名女性组成,平均年龄55.1±12.7岁。所有患者在手术前一周内进行了V/Q闪烁显像,我们回顾了最后一次BPA手术后1-3个月内的肺动脉造影。我们在肺动脉造影前或后1周内重复进行V/Q闪烁显像,在收集这些患者的临床和血流动力学参数时。我们根据术后残余肺动脉高压的存在将患者分为两组,并使用t检验比较术前和术后定量肺灌注缺陷百分比评分(PPDs%)。
■总之,对51例患者进行了102V/Q闪烁扫描。定量PPDs%与血流动力学指标平均肺动脉压(mPAP)呈正相关,肺血管阻力(PVR),和平均右心室压(RVP)(r分别为0.605、0.391和0.464,所有P<0.001),并且与6分钟步行距离(6MWD)呈负相关(r=-0.254,P=0.010)。术前平均定量PPD%为(49.0±15.6)%,术后为(33.5±13.9)%,差异有统计学意义(t=11.249,P<0.001)。术前定量PPDs%在残余肺动脉高压组和非残余肺动脉高压组分别为(54.7±15.7)%和(44.0±13.8)%,分别为(t=2.599,P=0.012)。术后定量PPDs%分别为(41.5±12.5)%和(26.3±11.0)%,在残余肺动脉高压组和非残余肺动脉高压组中,(t=4.647,P<0.001)。
■在这项研究中,我们发现SPECT肺V/Q闪烁显像的定量分析充分反映了CTEPH患者的肺动脉压和临床状况.我们的结果表明,它在预测CTEPH患者的残留肺动脉高压和评估BPA术后疗效方面具有明确的实用性。
UNASSIGNED: Single-photon emission computed tomography (SPECT) ventilation perfusion imaging is the main imaging method for the diagnosis of pulmonary embolism, and its application in the diagnosis and efficacy evaluation of chronic thromboembolic pulmonary hypertension (CTEPH) has been paid more and more attention. In recent years, with the development of computer software technology, ventilation/perfusion (V/Q) imaging quantitative analysis technology has become more and more mature. The objective of this study was to investigate the utility of quantitative analysis of pulmonary V/Q scintigraphy in evaluating the efficacy of balloon pulmonary angioplasty (BPA) in patients with CTEPH.
UNASSIGNED: In this retrospective analysis, we collected data of patients diagnosed with CTEPH who underwent BPA at the China-Japan Friendship Hospital from April 2018 to September 2020. The sample consisted of 23 males and 28 females, with an average age of 55.1±12.7 years. All patients underwent V/Q scintigraphy within one week before surgery, and we reviewed the pulmonary angiography within 1-3 months following the last BPA procedure. We repeated V/Q scintigraphy within 1 week before or after the pulmonary angiography, at the time of collecting clinical and hemodynamic parameters of these patients. We divided the patients into two groups based on the presence of residual pulmonary hypertension post-surgery and compared the pre- and post-operative quantitative pulmonary perfusion defect percentage scores (PPDs%) using the t-test.
UNASSIGNED: In all, 102 V/Q scintigraphy scans were performed in 51 patients. The quantitative PPDs% were positively correlated with the hemodynamic indexes mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and mean right ventricular pressure (RVP) (r=0.605, 0.391, and 0.464, respectively, all P<0.001) and negatively correlated with the 6-minute walking distance (6MWD) (r=-0.254, P=0.010). The average preoperative quantitative PPDs% were (49.0±15.6)% which significantly decreased to (33.5±13.9)% after surgery (t=11.249, P<0.001). The preoperative quantitative PPDs% were (54.7±15.7)% and (44.0±13.8)% in the residual pulmonary hypertension group and the non-residual pulmonary hypertension group, respectively (t=2.599, P=0.012). The postoperative quantitative PPDs% were (41.5±12.5)% and (26.3±11.0)%, in the residual pulmonary hypertension group and the non-residual pulmonary hypertension group, respectively (t=4.647, P<0.001).
UNASSIGNED: In this study, we found that quantitative analysis of SPECT pulmonary V/Q scintigraphy adequately reflected the pulmonary artery pressure and clinical status in patients with CTEPH. Our results demonstrate its definite utility in predicting residual pulmonary hypertension and in evaluating the postoperative efficacy of BPA in patients with CTEPH.