Longitudinal analysis of perfusion lung scintigrams of patients with unoperated chronic thromboembolic pulmonary hypertension

Nika Skoro-Sajer; Alexander Becherer; Walter Klepetko; Meinhard P. Kneussl; Gerald Maurer; Irene M. Lang

doi:10.1160/TH03-11-0727

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 92(01): 201-207
DOI: 10.1160/TH03-11-0727

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Longitudinal analysis of perfusion lung scintigrams of patients with unoperated chronic thromboembolic pulmonary hypertension

Nika Skoro-Sajer

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

,

Alexander Becherer

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

,

Walter Klepetko

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

,

Meinhard P. Kneussl

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

,

Gerald Maurer

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

,

Irene M. Lang

¹Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria Department of Nuclear Medicine, University of Vienna, Vienna, Austria

› Author Affiliations

Abstract

Summary

Chronic thromboembolic pulmonary hypertension (CTEPH) is the result of single or recurrent pulmonary thromboemboli that are thought to develop into organized pulmonary arterial obstructions by recurrent embolism and in situ thrombosis. Radioisotopic ventilation-perfusion scanning (V/Q scan) is a safe and highly sensitive test for pulmonary thromboembolic disease. The aim was to assess the natural history of thrombus expansion. We performed a prospective quantitative evaluation of ventilation/perfusion scintigrams (V/Q scans) in 20 patients with severe unoperated CTEPH. The baseline V/Q scan of each patient served as a reference for the second scan 21.7 ± 8.2 months later. Planar images with intravenous 99mTc-labeled human albumin macroaggregates were reconstructed in six standard projections. Perfusion scans were analyzed by a semiquantitative evaluation. In parallel, hemodynamics and clinical condition were prospectively observed. Lung perfusion scintigrams analyzed by a semi-quantitative method in patients with severe unoperated CTEPH show an apparent decrease of segmental flow abnormalities over time, paralleling right ventricular decline.

Keywords

Pulmonary embolism - perfusion lung scintigraphy - thrombosis - pulmonary hypertension

Full Text

References

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