Evaluation of anticoagulant therapy by pulmonary ventilation/perfusion imaging in patients with chronic thromboembolic pulmonary hypertension
10.3760/cma.j.issn.2095-2848.2018.07.006
- VernacularTitle:应用核素肺通气/灌注显像评估慢性血栓栓塞性肺动脉高压抗凝治疗疗效
- Author:
Dongzhu YANG
1
;
Dayong WU
;
Rongzheng MA
;
Feng GUO
;
Zongyao ZHANG
;
Kai HAN
;
Junling REN
;
Wei FANG
Author Information
1. 100037,北京协和医学院、中国医学科学院阜外医院核医学科
- Keywords:
Hypertension,pulmonary;
Pulmonary embolism;
Anticoagulants;
Treatment outcome;
Radionuclide imaging;
Technetium Tc 99m aggregated albumin;
Sodium pertechnetate Tc 99m
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2018;38(7):481-484
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of anticoagulant therapy by pulmonary ventilation/perfusion (V/Q) imaging in chronic thromboembolic pulmonary hypertension (CTEPH) patients.Methods Thirtysix CTEPH patients (16 males,20 females,average age:(53.8±13.8) years) diagnosed by pulmonary angiography from January 2013 to December 2015 were included in this retrospective study.All patients received anticoagulant therapy for more than 6 months.They underwent pulmonary V/Q imaging before and 6 months after anticoagulant therapy.The numbers of pulmonary segments with perfusion defect,percentage of perfusion defect score (PPDs) and pulmonary arterial systolic pressure (PASP) before and after anticoagulant therapy were measured by echocardiography.Pair t test was used for data analysis.Results Before anticoagulant therapy,there were 319 pulmonary segments with perfusion defect in 36 CTEPH patients,8.9± 3.4 on average,and reduced to 8.4+3.6 after anticoagulant therapy (t =3.101,P＜0.01).The PPDs before and after anticoagulant therapy were (43.3±19.7)％ and (40.8±+20.5)％ (t=2.364,P＜0.05).In the subgroup of 9 patients with improved pulmonary perfusion,the PASP significantly decreased from (68.7±27.3)to (56.1 +±34.8) mmHg (1 mm Hg =0.133 kPa;t =2.465,P＜ 0.05) after anticoagulant therapy.In contrast,in the subgroup of 27 patients with no improved pulmonary perfusion,the PASP before and after anticoagulant therapy were (71.3±26.9) and (76.7±35.0) mmHg respectively (t=-1.511,P＞0.05).Conclusion Pulmonary V/Q imaging is a reliable method for evaluating the changes of pulmonary perfusion before and after anticoagulant therapy,and it is valuable for assessing the effect of anticoagulant therapy in CTEPH patients.
