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Erschienen in: European Radiology 12/2018

25.05.2018 | Chest

Comparative clinical and predictive value of lung perfusion blood volume CT, lung perfusion SPECT and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty

verfasst von: Hirofumi Koike, Eijun Sueyoshi, Ichiro Sakamoto, Masataka Uetani, Tomoo Nakata, Kouji Maemura

Erschienen in: European Radiology | Ausgabe 12/2018

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Abstract

Objectives

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).

Methods

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.

Results

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%.

Conclusions

Lung PBV is a useful technique for evaluation of segmental lung perfusion and its improvement in patients with CTEPH.

Key Points

• 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.
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Metadaten
Titel
Comparative clinical and predictive value of lung perfusion blood volume CT, lung perfusion SPECT and catheter pulmonary angiography images in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty
verfasst von
Hirofumi Koike
Eijun Sueyoshi
Ichiro Sakamoto
Masataka Uetani
Tomoo Nakata
Kouji Maemura
Publikationsdatum
25.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 12/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5501-4

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