Evaluating efficacy of pulmonary thromboendarterectomy in treatment of chronic thromboembolic pulmonary hypertension using pulmonary perfusion tomography
10.13929/j.1003-3289.201703004
- VernacularTitle:肺灌注断层显像评价肺动脉血栓内膜剥脱术对慢性血栓栓塞性肺动脉高压的疗效
- Author:
Xiaoying XI
;
Bixi CHEN
;
Wei GAO
;
Tie WANG
;
Minfu YANG
- Keywords:
Hypertension,pulmonary;
Thrombosis;
Pulmonary artery;
Endarterectomy;
Pulmonary perfusion tomography
- From:Chinese Journal of Medical Imaging Technology
2017;33(8):1148-1152
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of pulmonary thromboendarterectomy (PTE) in treatment of chronic thromboembolic pulmonary hypertension (CTEPH) using 99Tcm-macroaggregated albumin (99 Tcm-MAA) pulmonary perfusion tomography.Methods Sixteen patients with CTEPH underwent 99Tcm-MAA pulmonary perfusion tomography before and 6-12 months after PTE.The perfusion defects and improvement both in pulmonary lobe and segment were observed pre-and post-PTE.Percentage of perfusion defect scores (PPDs％) were calculated and the change of systolic pulmonary artery pressure (SPAP) measured by echocardiography was also recorded.Results The postoperative SPAP was significantly lower than that before surgery ([36.56±8.47] mmHg vs [90.52±14.55] mmHg,t=14.14,P＜0.001).Before PTE,perfusion abnormalities were identified in 86 (86/96,89.58％) pulmonary lobes of 16 patients.In all of the 86 abnormal lobes,21 (21/86,24.42％) became normal,and the remaining 65 (65/86,75.58％) were improved after PTE.Perfusion defects were confirmed in 230 (230/304,75.66％) pulmonary segments of 16 patients before surgery.In all of the 230 abnormal segments,73 (73/230,31.74％) became normal,74 (74/230,32.17％) were improved and 83 (83/230,36.09％) remained unchanged after PTE.The mean PPDs％ decreased from (56.79±14.54)％ pre PTE to (28.20±15.24)％ at 6 12 months after PTE.The PPDs％ was positively correlated with homochronous SPAP (r=0.68,P＜0.001).Conclusion PTE can significantly reduce SPAP and improve the pulmonary perfusion in CTEPH patients.Pulmonary perfusion imaging can evaluate the curative effect of PTE.
