Comparison between pulmonary ventilation/perfusion scintigraphy and CT pulmonary angiography at different levels of embolus

doi:10.3969/j.issn.1006-7795.2013.01.005

Abstract

Abstract:

Objective To compare the effects of ventilation/perfusion scan and the computed tomography pulmonary angiography in the localization of the thromboembolism.Methods Data of 39 consecutive patients [28 male and 11 female, aged range (51.0±16.1)yeas] with final diagnosis of chronic thromboembolic pulmonary hypertension by clinical assessment, laboratory examinations and X-ray pulmonary angiography were retrospectively analyzed. Of the 39 patients,4 had recent surgery, 7 had comorbidity of heart-failure,12 had previous coexistence of acute pulmonary embolism, 26 had lower limb deep vein thrombosis. In Clinical Wells score,17 cases had the high probability, 22 cases had the moderate possibility. All patients accepted V/Q SPECT imaging, CT pulmonary angiography and X-ray pulmonary angiography. The time phase was no more than 7 days. Independent readers reviewed and recorded the three examinations of the segmental and subsegmental pulmonary artery involved in chronic thromboembolic pulmonary hypertension (CTEPH). SPSS software version 13.0 was used for the statistical analyses.Results All the patients successfully underwent the mentioned examinations. At the segmental level, the ventilation-perfusion V/Q single photon emission CT (SPECT) scan had the diagnostic accuracy of 90.9%, sensitivity of 84.7%, specificity of 94.6%. The CTPA imaging had a diagnostic accuracy of 91.2%, sensitivity of 77.7%, specificity of 98.2%. At the subsegmental level, the V/Q SPECT scintigraphy had a diagnostic accuracy of 93.8%, sensitivity of 63.2%, specificity of 94.8% and CTPA imaging had a diagnostic accuracy of 83.9%, sensitivity of 50.4%, and specificity of 94.8%. Conclusion V/Q SPECT scan has a high sensitivity in the localization of the embolus. In clinical practice, if V/Q imaging is normal, CTEPH can be excluded; if it shows abnormal images, CTPA, PAG and MRI may be needed to further clarify the diagnosis.

Key words: pulmonary hypertension, chronic, pulmonary ventilation/perfusion scan, pulmonary artery angiography, computed tomography

CLC Number:

R445
R563.5

KAN Ying, WANG Tie. Comparison between pulmonary ventilation/perfusion scintigraphy and CT pulmonary angiography at different levels of embolus[J]. Journal of Capital Medical University, 2013, 34(1): 23-28.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.01.005

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I1/23

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