Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Eur Radiol. 2018 Dec;28(12):5091-5099. doi: 10.1007/s00330-018-5501-4. Epub 2018 May 25.
Lung perfusion blood volume (PBV) using dual-energy computed tomography has recently become an accepted technique for diagnosing pulmonary thromboembolism. We evaluated the correlation among lung PBV, single-photon emission computed tomography (SPECT) and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA).
In total, 17 patients and 57 sessions were evaluated with the three modalities. Segmental lung perfusion and its improvement in lung PBV and SPECT were compared with catheter pulmonary angiography as the reference standard before and after BPA.
The sensitivity for detecting segmental perfusion defects using SPECT and lung PBV was 85% and 92%, the specificity was 99% and 99%, the accuracy was 92% and 95%, the positive predictive value was 99% and 99%, and the negative predictive value was 88% and 93%. The sensitivity for detecting segmental perfusion improvement using SPECT and lung PBV was 61% and 69%, the specificity was 75% and 83%, the accuracy was 62% and 70%, the positive predictive value was 97% and 98%, and the negative predictive value was 12% and 16%.
Lung PBV is a useful technique for evaluation of segmental lung perfusion and its improvement in patients with CTEPH.
• BPA is a new treatment for patients with CTEPH. • Lung PBV images may be more sensitive for pulmonary blood flow. • The current work demonstrates that Lung PBV images are useful in evaluating patients with CTEPH. • The current work demonstrates that Lung PBV is useful in gauging the treatment effect of BPA.
双能 CT 肺灌注血容量（PBV）最近已成为诊断肺血栓栓塞症的一种公认技术。我们评估了慢性血栓栓塞性肺动脉高压（CTEPH）患者在球囊肺动脉成形术（BPA）前后肺 PBV、单光子发射计算机断层扫描（SPECT）和导管肺动脉造影图像之间的相关性。
共评估了 17 例患者的 57 次检查，采用三种方法评估。比较了肺 PBV 和 SPECT 的节段性肺灌注及其改善情况与导管肺动脉造影作为 BPA 前后的参考标准。
SPECT 和肺 PBV 检测节段性灌注缺损的灵敏度分别为 85%和 92%，特异性分别为 99%和 99%，准确性分别为 92%和 95%，阳性预测值分别为 99%和 99%，阴性预测值分别为 88%和 93%。SPECT 和肺 PBV 检测节段性灌注改善的灵敏度分别为 61%和 69%，特异性分别为 75%和 83%，准确性分别为 62%和 70%，阳性预测值分别为 97%和 98%，阴性预测值分别为 12%和 16%。
肺 PBV 是评估 CTEPH 患者节段性肺灌注及其改善的有用技术。
• BPA 是 CTEPH 患者的一种新的治疗方法。• 肺 PBV 图像可能对肺血流更敏感。• 目前的工作表明，肺 PBV 图像在评估 CTEPH 患者方面是有用的。• 目前的工作表明，肺 PBV 对评估 BPA 的治疗效果很有用。
