慢性血栓栓塞性肺动脉高压患者SPECT/CT肺灌注体积及视觉评分与血流动力学参数的相关性研究

目的:探讨慢性血栓栓塞性肺动脉高压(CTEPH)患者肺灌注SPECT/CT显像肺灌注体积及视觉评分与右心导管血流动力学参数的相关性。方法:回顾性分析2015年3月至2019年7月间广州医科大学附属第一医院51例连续CTEPH患者的资料，其中男17例，女34例，年龄(59±12)岁。所有患者均行肺灌注SPECT/CT显像...

Correlation analysis of perfused lung volumes and visual scores using perfusion SPECT/CT and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension

Objective To investigate the correlations between perfused lung volumes,visual scores(using perfusion SPECT/CT)and right-heart catheter(RHC)hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension(CTEPH).Methods A total of 51 consecutive CTEPH patients(17 males,34 females,age(59±12)years)in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed.All patients underwent lung perfusion SPECT/CT imaging and RHC examinations.Perfused lung volumes were determined using threshold-based(15%-85%)segmentation.Visual semiquantitative scoring in each lung segment was performed using Begic method.RHC hemodynamic parameters including pulmonary artery systolic pressure(PASP),pulmonary arterial diastolic pressure(PADP),mean pulmonary artery pressure(mPAP),pulmonary arteriolar wedge pressure(PAWP),pulmonary vessel resistance(PVR),cardiac output(CO),cardiac index(CI)were recorded.Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes,visual scores and hemodynamic parameters.Results There were significant correlations between perfused lung volumes(30%-70%threshold)and mPAP(rs values:from-0.414 to-0.302,all P<0.05).Among them,perfused lung volumes under the threshold of 40%and 45%were moderately correlated with mPAP(rs values:-0.414,-0.412,both P<0.05).Perfused lung volume(40%threshold)was moderately negatively correlated with PASP,PADP(rs values:-0.402,-0.440,both P<0.05),and slightly negatively correlated with PVR(rs=-0.352,P<0.05).Visual scores were slightly positively correlated with the PADP(rs=0.311,P<0.05),while there was no correlation between visual scores and other RHC hemodynamic parameters(rs values:from-0.201 to 0.275,all P>0.05).Conclusion Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.