Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA): Preliminary results
Quantification of lung perfusion blood volume (lung PBV) by dual-energy CT in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after balloon pulmonary angioplasty (BPA): Preliminary results
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DOI：
10.1016/j.ejrad.2016.06.016
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发表时间：
2016-09-01
影响因子：
3.3
通讯作者：
Maemura, Kouji
中科院分区：
文献类型：
--
作者：
Koike, Hirofumi;Sueyoshi, Eijun;Maemura, Kouji
目的：球囊肺血管成形术（BPA）是慢性血栓栓塞性肺动脉高压（CTEPH）患者的一种治疗选择。其对肺灌注的影响尚未量化;我们在接受BPA的CTEPH患者中使用双能量计算机断层扫描（DECT）检查肺血容量（PBV）的临床意义。在这项对8例CTEPH女性患者的16例BPA进行的回顾性研究中，我们评价了双肺（n = 16）、右肺或左肺（n = 32），以及BPA前后使用DECT的三个右或左段（上、中、下）（n = 96）PBV。我们评估了肺PBV改善与肺动脉（PA）压（PAP）、心脏指数（CI）、肺血管阻力（PVR）和6分钟步行距离之间的关系。结果：BPA治疗前和治疗后6节段肺PBV/PAenh分别为0.067 ± 0.021和0.077 ± 0.019（p < 0.0001）。BPA治疗前后两肺PBV/PAenh和PAP的改善之间存在显著的正相关性（R=0.69，p = 0.005），PVR（R = 0.56，p = 0.03）和6分钟步行距离结论：BPA后PBV的改善反映了肺灌注的增加，与PAP、PVR和6分钟步行距离呈正相关。肺PBV可作为BPA治疗效果的一个指标。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Objectives: Balloon pulmonary angioplasty (BPA) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Its effect on pulmonary perfusion has not been quantified; we examined the clinical significance of pulmonary blood volume (PBV) using dual-energy computed tomography (DECT) in patients with CTEPH undergoing BPA.Methods: In this retrospective study of 16 BPAs in eight female patients with CTEPH, we evaluated both lung (n = 16), right-or left -lung (n = 32), and three right- or left-segment (upper, middle, and lower) (n = 96) PBVs before and after BPA, using DECT. We evaluated the relationships between improvement in lung PBV and pulmonary artery (PA) pressure (PAP), cardiac index (CI), pulmonary vascular resistance (PVR), and 6-min walking distance. We measured PA enhancement (PAenh) on DECT images and calculated lung PBV/PAenh to adjust timing.Results: Pre- and post-BPA 6-segment lung PBV/PAenh were 0.067 + 0.021 and 0.077 + 0.019, respectively, in the treated segment (p < 0.0001). There were significant positive correlations between pre- to post-BPA improvements in both -lung PBV/PAenh and PAP (R=0.69, p = 0.005), PVR (R = 0.56, p = 0.03), and 6-min walking distance (R = 0.67, p = 0.01).Conclusions: Improved PBV after BPA, reflecting increased lung perfusion, was positively correlated with PAP, PVR, and 6-min walking distance. Lung PBV may be an indicator of BPA treatment effect. (C) 2016 Elsevier Ireland Ltd. All rights reserved.