Cherniavskiĭ A M, Aliapkina E M, Terekhov I N, Cherniavskiĭ M A, Edemskiĭ A G
Angiol Sosud Khir. 2013;19(1):118-23.
Perfusion scintigraphy of the lungs is used as screening in order to confirm thrombormbolic genesis of pulmonary hypertension. Meanwhile, perfusion scintigraphy is a non-invasive and objective method of assessing haemocirculation in the pulmonary tissue. Using the quantitative method of calculation of the perfusion deficit, one may judge about efficiency of the treatment performed and to assess the dynamics of the state of the micro- circulatory bed of the lung. We examined a total of 53 patients presenting with chronic postembolic pulmonary hypertension, who underwent pulmonary thromboendarterectomy. Pulmonary tissue blood flow was assessed by means of perfusion scintigraphy prior to operation, and in the early postoperative (3 weeks after operation) and remote (6 months and more) periods. Analysing the values of perfusion deficit in patients depending on the pulmonary hypertension degree we revealed close correlation dependence between the perfusion deficit and pulmonary hypertension, i. e., increased pressure in the pulmonary artery was accompanied by a decreased defect of lung perfusion according to the findings of perfusion scintigraphy. Analyzing the findings of perfusion scintigraphy in patients presenting with chronic postembolic pulmonary hypertension prior to surgery, in the immediate and remote postoperative periods in all groups showed a statistically significant decrease in the perfusion deficit. It was demonstrated that the method of perfusion pulmonary scintigraphy reliably reflects the alterations in the pulmonary tissue perfusion after lung pulmonary thromboendarterectomy, thereby reflecting efficiency of surgical treatment. With the initially pronounces pulmonary hypertension, improvement of lung perfusion obtained at the hospital stage also continues in the remote period.
肺灌注闪烁扫描用于筛查，以确认肺动脉高压的血栓形成起源。同时，肺灌注闪烁扫描是评估肺组织血液循环的一种非侵入性客观方法。使用灌注缺损的定量计算方法，可以判断所进行治疗的效果，并评估肺微循环床状态的动态变化。我们共检查了53例慢性栓塞后肺动脉高压患者，这些患者均接受了肺动脉血栓内膜切除术。在手术前、术后早期（术后3周）和远期（6个月及更长时间）通过灌注闪烁扫描评估肺组织血流。根据肺动脉高压程度分析患者的灌注缺损值，我们发现灌注缺损与肺动脉高压之间存在密切的相关性，即根据灌注闪烁扫描结果，肺动脉压力升高伴随着肺灌注缺损减少。分析所有组慢性栓塞后肺动脉高压患者术前、术后即刻和远期的灌注闪烁扫描结果显示，灌注缺损有统计学意义的下降。结果表明，肺灌注闪烁扫描方法能可靠地反映肺动脉血栓内膜切除术后肺组织灌注的变化，从而反映手术治疗的效果。对于最初有明显肺动脉高压的患者，住院阶段获得的肺灌注改善在远期也持续存在。
