Evaluation of the efficacy of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension using pulmonary perfusion tomography imaging
10.3760/cma.j.cn321828-20210428-00142
- VernacularTitle:肺灌注断层显像评价肺动脉球囊扩张成形术对慢性血栓栓塞性肺动脉高压的疗效
- Author:
Jiaoyan WU
1
;
Jianfeng WANG
;
Dandan YAO
;
Wei WANG
;
Juanni GONG
;
Yuanhua YANG
;
Minfu YANG
Author Information
1. 首都医科大学附属北京朝阳医院核医学科，北京 100020
- Keywords:
Hypertension, pulmonary;
Thromboembolism;
Angioplasty, balloon;
Tomography, emission-computed, single-photon;
Technetium Tc 99m aggregated albumin
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2023;43(1):1-5
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) using 99Tc m-macroaggregated albumin (MAA) pulmonary perfusion tomography imaging. Methods:Twenty-five patients (4 males, 21 females; age (56.5±12.3) years) with CTEPH who underwent BPA from January 2017 to April 2020 in Beijing Chaoyang Hospital, Capital Medical University were enrolled retrospectively. Effect of BPA on the improvement of pulmonary lobe/pulmonary segment perfusion was analyzed, and the proportions of improved and unimproved pulmonary lobe/pulmonary segment perfusion by BPA were calculated. The percentages of perfusion defect scores (PPDs%) of lung perfusion tomography imaging before BPA and after 4-6 times BPA were compared and analyzed (paired t test). The correlations between PPDs% and mean pulmonary artery pressure (mPAP) before BPA and after BPA were analyzed respectively, and the correlation between decreased percentage of PPDs% and decreased percentage of mPAP after BPA were also analyzed (Pearson correlation analysis). Results:Among 150 lobes of 25 patients, 96.00%(144/150) lobes showed perfusion abnormalities before BPA. After BPA, 11.11%(16/144) showed complete improvement, 57.64%(83/144) showed partial improvement, and 31.25%(45/144) showed no improvement. Among 450 pulmonary segments of 25 patients, 62.44%(281/450) showed perfusion abnormalities before BPA. After BPA, 30.60%(86/281), 37.37%(105/281), 32.03%(90/281) showed complete, partial and no improvement, respectively. The post-BPA PPDs% was significantly lower than that of pre-BPA ((39.08±10.88)% vs (57.88±10.46)%; t=10.40, P<0.001). The post-BPA mPAP was significantly lower than that of pre-BPA ((32.36±10.57) vs (49.08±10.23) mmHg; 1 mmHg=0.133 kPa; t=10.25, P<0.001). There was no significant correlation between PPDs% and mPAP either before BPA ( r=0.01, P=0.953) or after BPA ( r=0.27, P=0.199), but there was a positive correlation between the changes of PPDs% and mPAP ( r=0.40, P=0.045). Conclusions:BPA can significantly improve the pulmonary perfusion and reduce mPAP in CTEPH patients. Pulmonary perfusion tomography imaging can be used to evaluate the efficacy of BPA in CTEPH.
