Yilmaz Farise, Tunçez Abdullah, Önner Hasan, Gedik Gonca Kara, Uysal Emine, Körez Muslu Kazım
Selcuk University Medical Faculty, Department of Nuclear Medicine, Konya, Turkey.
Hell J Nucl Med. 2022 May-Aug;25(2):168-176. doi: 10.1967/s002449912478. Epub 2022 Aug 3.
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).
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.
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.
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.
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。
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。
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。
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。