■我们旨在使用肺灌注SPECT/CT的半定量分析研究慢性血栓栓塞性肺动脉高压(CTEPH)对球囊肺血管成形术(BPA)的反应。
■这是一项针对2015年至2022年间接受BPA以及BPA前后肺灌注SPECT/CT的CTEPH患者的单中心回顾性研究。根据改良的PIOPEDII标准,目视评估SPECT/CT上的节段性缺陷,并将其半定量评分为1(大缺陷)或0.5(中度缺陷)。灌注缺损评分定义为(Σ节段性缺损评分/18)×100(%)。灌注缺损评分与血流动力学或功能参数(包括WHO功能等级)之间的关联,六分钟步行距离(6MWD),血清B型利钠肽(BNP),平均动脉肺动脉压(mPAP),肺血管阻力(PVR),和三尖瓣反流压力梯度(TRPG)在超声心动图上进行统计学分析。
■共纳入24例连续患者。BPA后灌注缺损评分明显改善(中位数58.3%vs.47.2%,P<0.001),结合世界卫生组织的职能类别,6MWD,血清BNP,mPAP,TRPG。灌注缺损评分与6MWD显著相关(rho=-0.583,P<0.001),血清BNP(rho=0.514,P<0.001),mPAP(rho=0.583,P<0.001),和PVR(rho=0.575,P<0.001)。灌注缺损评分的改善与mPAP的改善显著相关(rho=0.844,P<0.001)。
■我们的结果表明,肺灌注SPECT/CT的半定量分析可以为监测BPA的功效提供潜在的成像生物标志物。
■在线版本包含补充材料,可在10.1007/s13139-024-00858-1获得。
UNASSIGNED: We aimed to investigate the response to balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) using semi-quantitative analysis of lung perfusion SPECT/CT.
UNASSIGNED: This is a single-center retrospective study of patients with CTEPH who underwent BPA and pre- and post-BPA lung perfusion SPECT/CT between 2015 and 2022. Segmental defects on SPECT/CT were visually assessed and semi-quantitatively scored as 1 (large defect) or 0.5 (moderate defect) in accordance with modified PIOPED II criteria. The perfusion defect score was defined as (Σ segmental defect scores/18) × 100 (%). Associations between perfusion defect score and hemodynamic or functional parameters including WHO functional class, six-minute walking distance (6MWD), serum B-type natriuretic peptide (BNP), mean arterial pulmonary pressure (mPAP), pulmonary vascular resistance (PVR), and tricuspid regurgitation pressure gradient (TRPG) on echocardiography were statistically analyzed.
UNASSIGNED: A total of 24 consecutive patients were included. The perfusion defect score significantly improved after BPA (median 58.3% vs. 47.2%, P < 0.001), in conjunction with the WHO functional class, 6MWD, serum BNP, mPAP, and TRPG. Perfusion defect scores were significantly correlated with 6MWD (rho = - 0.583, P < 0.001), serum BNP (rho = 0.514, P < 0.001), mPAP (rho = 0.583, P < 0.001), and PVR (rho = 0.575, P < 0.001). The improvement in the perfusion defect score was significantly associated with improvement in mPAP (rho = 0.844, P < 0.001).
UNASSIGNED: Our results suggest that semi-quantitative analysis of lung perfusion SPECT/CT can provide a potential imaging biomarker for monitoring the efficacy of BPA.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s13139-024-00858-1.