Perfusion Scintigraphy in Diagnosis and Management of Thromboembolic Pulmonary Hypertension

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening complication of acute pulmonary embolism (PE). Because the treatment of CTEPH is markedly different from that of other types of pulmonary hypertension, lung ventilation-perfusion (V/Q) scintigraphy is recommended for the workup of patients with unexplained pulmonary hypertension. Lung V/Q scintigraphy is superior to CT pulmonary angiography for detecting CTEPH. Perfusion defect findings of CTEPH can be different from those of acute PE. Familiarity with the patterns of perfusion defects seen during the initial workup of CTEPH and the expected posttreatment changes seen at follow-up imaging is essential for accurate interpretation of V/Q scintigraphy findings. ©

A Prospective, Comparative Study of Ventilation–Perfusion Planar Imaging and Ventilation–Perfusion SPECT for Chronic Thromboembolic Pulmonary Hypertension

“…jnm.snmjournals.org Downloaded from angioplasty (20,21), which are the most promising treatments for improving symptoms and prognoses in eligible patients with CTEPH (12). Thus, although our results suggested that V/Q-SPECT is no more effective than Planar V/Q for diagnosing CTEPH in individual patients, its greater sensitivity may be advantageous for certain therapeutic approaches and for postoperative assessments of newly acute PE (22).…”

The prevalence of pulmonary embolism in non-hospitalised de-isolated patients diagnosed with mild COVID-19 disease

“…However, CTPA has limitations in the diagnosis of chronic PE and detection of peripheral emboli, for which it has low sensitivity. [12,19] In our study, we had two cases of falsenegative CTPA studies, with a positive VQ SPECT/CT study performed the same day (Fig. 4).…”

Chronic Thromboembolic Pulmonary Hypertension: the Bedside

“…A normal V/Q scan essentially rules out CTEPH with a negative predictive value of 100% [40]. In IPAH, the V/Q scan can be normal, have a "mottled" appearance, or subsegmental defects [41]. With CTEPH, the V/Q scan shows segmental or larger mismatched perfusion defects (Figure 2A).…”