Clinical Investigations
Evaluation of the efficacy of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension using pulmonary perfusion tomography imaging
Wu Jiaoyan, Wang Jianfeng, Yao Dandan, Wang Wei, Gong Juanni, Yang Yuanhua, Yang Minfu
Published 2023-01-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(1): 1-5. DOI: 10.3760/cma.j.cn321828-20210428-00142
Abstract
ObjectiveTo evaluate the efficacy of balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) using 99Tcm-macroaggregated albumin (MAA) pulmonary perfusion tomography imaging.
MethodsTwenty-five patients (4 males, 21 females; age (56.5±12.3) years) with CTEPH who underwent BPA from January 2017 to April 2020 in Beijing Chaoyang Hospital, Capital Medical University were enrolled retrospectively. Effect of BPA on the improvement of pulmonary lobe/pulmonary segment perfusion was analyzed, and the proportions of improved and unimproved pulmonary lobe/pulmonary segment perfusion by BPA were calculated. The percentages of perfusion defect scores (PPDs%) of lung perfusion tomography imaging before BPA and after 4-6 times BPA were compared and analyzed (paired t test). The correlations between PPDs% and mean pulmonary artery pressure (mPAP) before BPA and after BPA were analyzed respectively, and the correlation between decreased percentage of PPDs% and decreased percentage of mPAP after BPA were also analyzed (Pearson correlation analysis).
ResultsAmong 150 lobes of 25 patients, 96.00%(144/150) lobes showed perfusion abnormalities before BPA. After BPA, 11.11%(16/144) showed complete improvement, 57.64%(83/144) showed partial improvement, and 31.25%(45/144) showed no improvement. Among 450 pulmonary segments of 25 patients, 62.44%(281/450) showed perfusion abnormalities before BPA. After BPA, 30.60%(86/281), 37.37%(105/281), 32.03%(90/281) showed complete, partial and no improvement, respectively. The post-BPA PPDs% was significantly lower than that of pre-BPA ((39.08±10.88)% vs (57.88±10.46)%; t=10.40, P<0.001). The post-BPA mPAP was significantly lower than that of pre-BPA ((32.36±10.57) vs (49.08±10.23) mmHg; 1 mmHg=0.133 kPa; t=10.25, P<0.001). There was no significant correlation between PPDs% and mPAP either before BPA (r=0.01, P=0.953) or after BPA (r=0.27, P=0.199), but there was a positive correlation between the changes of PPDs% and mPAP (r=0.40, P=0.045).
ConclusionsBPA can significantly improve the pulmonary perfusion and reduce mPAP in CTEPH patients. Pulmonary perfusion tomography imaging can be used to evaluate the efficacy of BPA in CTEPH.
Key words:
Hypertension, pulmonary; Thromboembolism; Angioplasty, balloon; Tomography, emission-computed, single-photon; Technetium Tc 99m aggregated albumin
Contributor Information
Wu Jiaoyan
Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Wu Jiaoyan is working on the Department of Radiology, Beijing Huairou Hospital, Beijing 101400, China
Wang Jianfeng
Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Yao Dandan
Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Wang Wei
Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Gong Juanni
Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Yang Yuanhua
Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Yang Minfu
Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
