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V/Q单光子发射计算机断层扫描(SPECT)和CT肺动脉造影(CTPA)这两种非侵入性诊断方法对于检测慢性血栓栓塞性肺动脉高压(CTEPH)(一种可治疗的肺动脉高压病因)的诊断兼容性。

Diagnostic compatibility of V/Q SPECT and CTPA, which are non-invasive diagnostic methods, for the detection of CTEPH, which is a treatable cause of pulmonary hypertension.

作者信息

Yilmaz Farise, Tunçez Abdullah, Önner Hasan, Gedik Gonca Kara, Uysal Emine, Körez Muslu Kazım

机构信息

Selcuk University Medical Faculty, Department of Nuclear Medicine, Konya, Turkey.

出版信息

Hell J Nucl Med. 2022 May-Aug;25(2):168-176. doi: 10.1967/s002449912478. Epub 2022 Aug 3.

Abstract

OBJECTIVE

To evaluate the compatibility between ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT) scintigraphy and computed tomography pulmonary angiography (CTPA) in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH).

SUBJECT AND METHODS

Twenty cases of CTEPH, out of 98 patients with pre-diagnosis of pulmonary hypertension (PH), who was diagnosed with CTEPH with a multidisciplinary approach and a council decision, were included in the study retrospectively. The diagnostic performances of V/Q SPECT and CTPA, which are used as noninvasive methods in diagnosing CTEPH, and the compatibility between them were calculated statistically.

RESULTS

Of 20 patients diagnosed with CTEPH, 12 were female, and 8 were male; the mean age was 59.1 (range: 36-79). The sensitivity of V/Q SPECT scintigraphy of imaging methods used to diagnose CTEPH was 90%, CTPA was 80%, specificities were 88% and 92%, respectively, and accuracy was 88% in both cases methods. According to the reference standard, the kappa value for V/Q scintigraphy was calculated as 0.765 and 0.678 for CTPA. These values were statistically significant (P<0.01), and there was a substantial concordance between them.

CONCLUSION

There is significant compatibility between V/Q SPECT scintigraphy and CTPA in diagnosing CTEPH, whose differential diagnosis is essential because of its high cure potential due to PH causes.

摘要

目的

评估通气/灌注(V/Q)单光子发射计算机断层扫描(SPECT)闪烁显像与计算机断层扫描肺动脉造影(CTPA)在诊断慢性血栓栓塞性肺动脉高压(CTEPH)中的兼容性。

对象与方法

回顾性纳入98例预诊断为肺动脉高压(PH)的患者中,经多学科方法及会诊确诊为CTEPH的20例患者。计算作为诊断CTEPH的非侵入性方法的V/Q SPECT和CTPA的诊断性能及其之间的兼容性。

结果

20例确诊为CTEPH的患者中,女性12例,男性8例;平均年龄59.1岁(范围:36 - 79岁)。用于诊断CTEPH的成像方法中,V/Q SPECT闪烁显像的敏感性为90%,CTPA为80%,特异性分别为88%和92%,两种方法的准确性均为88%。根据参考标准,V/Q闪烁显像的kappa值计算为0.765,CTPA为0.678。这些值具有统计学意义(P<0.01),且两者之间存在高度一致性。

结论

V/Q SPECT闪烁显像与CTPA在诊断CTEPH方面具有显著的兼容性,由于其因PH病因具有较高的治愈潜力,其鉴别诊断至关重要。

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