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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• 作者：Hirofumi Koike^a ; ^{kei16231623@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Eijun Sueyoshi^a ; ^{sueyo@nagasaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Ichiro Sakamoto^a ; ^{ichiro-s@nagasaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Masataka Uetani^a ; ^{uetani@nagasaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Tomoo Nakata^b ; ^{t-nakata@nagasaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Kouji Maemura^b ; ^{maemura@nagasaki-u.ac.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Balloon pulmonary angioplasty (BPA) ; Chronic thromboembolic pulmonary hypertension (CETPH) ; Pulmonary perfusion ; Pulmonary blood volume (PBV) ; Dual-energy computed tomography (DECT)
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：85
• 期：9
• 页码：1607-1612
• 全文大小：1515 K

文摘

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.