Reverse Ventilation-Perfusion Mismatch

Palmaz, Julio C.; Barnett, Charles A.; Reich, Stanley B.; Krumpe, Peter E.; Farrer, Paul A.

doi:10.1097/00003072-198401000-00003

Cited by 10 publications

(8 citation statements)

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“…The segments with V-Q imbalance were seen in approximately 20% of the total lung segments in baseline and the reversed-mismatched V/Q pattern was the most common V-Q imbalance pattern. This V/Q pattern may suggest that ventilation is more severely impaired than perfusion and could be indicative of airway disease with incomplete hypoxic vasoconstriction in COPD patients 20,21. As well in our study, the reversed-mismatched V/Q pattern was mostly seen in the area with bronchial wall thickening.…”

Section: Discussionsupporting

confidence: 82%

<p>Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis</p>

Hwang

Lee

et al. 2019

COPD

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PurposeTo assess changes in regional ventilation (V), perfusion (Q), and V-Q mismatch in patients with chronic obstructive pulmonary disease (COPD) after pharmacologic treatment using combined xenon-enhanced V and iodine-enhanced Q dual-energy CT (DECT).Patients and methodsCombined V and Q DECT were performed at baseline and after three-month pharmacologic treatment in 52 COPD patients. Anatomically co-registered virtual non-contrast images, V, Q, and V/Qratio maps were obtained. V/Q pattern was visually determined to be matched, mismatched, or reversed-mismatched and compared with the regional parenchymal disease patterns of each segment. DECT parameters for V, Q, and V-Q imbalance were quantified.ResultsThe parenchymal patterns on CT were not changed at follow-up. The segments with matched V/Q pattern were increased (80.2% to 83.6%) as the segments with reversed-mismatched V/Q pattern were decreased with improving ventilation (17.6% to 13.8%) after treatment. Changes of V/Q patterns were mostly observed in segments with bronchial wall thickening. Compared with patients without bronchial wall thickening, the quantified DECT parameters of V-Q imbalance were significantly improved in patients with bronchial wall thickening (p < 0.05). Changes in forced expiratory volume in one second after treatment were correlated with changes in the quantified DECT parameters (r = 0.327–0.342 or r = −0.406 and −0.303; p < 0.05).ConclusionDECT analysis showed that the V-Q imbalance was improved after the pharmacological treatment in COPD patients, although the parenchymal disease patterns remained unchanged. This improvement of V-Q imbalance may occur mostly in the areas with bronchial wall thickening.

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Section: Discussionsupporting

confidence: 82%

<p>Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis</p>

Hwang

Lee

et al. 2019

COPD

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“…It can be a sign of airway disease with incomplete hypoxic vasoconstriction that could lead to shunting and hypoxemia (Fig.6) [38]. Reverse mismatch might also be seen in pneumonia [18].…”

Section: Discussionmentioning

confidence: 99%

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Jögi

Ekberg

Jonson

et al. 2011

Eur J Nucl Med Mol Imaging

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“…Patterns typical of diagnoses other than PE are frequently observed in V/P scintigraphy [3][4][5]8,9,15,[24][25][26], but this is not taken into account in common interpretation criteria. As an example, the widely applied criteria from the PIOPED study [27] imply that pathological ventilation patterns lead to nondiagnostic characterization.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, diagnosis of PE is based on absent perfusion with preserved ventilation, a socalled mismatch. When interpreting combined ventilation and perfusion images, it is possible to differentiate patterns characteristic of diseases other than PE [3][4][5][6][7][8][9]. This is a regular practice in our department.…”

Section: Introductionmentioning

confidence: 99%

Role of fluorodeoxyglucose-PET versus fluorodeoxyglucose-PET/computed tomography in detection of unknown primary tumor: a meta-analysis of the literature

Jögi

Palmer²,

Jonson³

et al. 2008

Nuclear Medicine Communications

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The objectives of this study were to evaluate the diagnostic accuracy of fluorodeoxyglucose (FDG)-PET and FDG-PET/computed tomography (CT) in the detection of primary tumors in patients presenting with carcinoma of unknown primary (CUP) unidentified by conventional workup, and to compare the statistical difference between the FDG-PET and FDG-PET/CT. Twenty-eight studies (involving a total of 910 patients) published between 1990 and 2007 were reviewed. These studies evaluated the role of FDG-PET and FDG-PET/CT in the detection of unknown primary tumors after physical examination and conventional workup failed to detect a primary tumor. Systematic methods were used to identify, select, and evaluate the methodological quality of the studies as well as to summarize the overall findings of sensitivity, specificity, and detection capacity of the primary tumor. The overall sensitivity and specificity of FDG-PET in detecting unknown primary tumors were 0.78 [95% confidence interval (CI): 0.72-0.84)] and 0.79 (95% CI: 0.74-0.83), respectively. Furthermore, FDG-PET detected 28.54% of tumors that were not apparent after CUP failed to be detected by conventional workup. Data were collected on the locations of primary tumors detected by FDG-PET in 17 studies and detected by FDG-PET/CT in seven studies. Tumors from the base of the tongue accounted for 20.7% (six of 29) of all false-positive FDG-PET scans, corresponding to a false-positive rate of 28.6% (six of 29), much higher than tumors from the others. FDG-PET exhibited a lower sensitivity with respect to the tumors at the base of the tongue and tonsils, which was 68.2 and 76.7%, respectively. In the eight studies with 430 patients diagnosed with CUP by FDG-PET/CT, 31.4% (n=135) of primary tumors were detected. The pooled sensitivity and specificity were 0.81 (95% CI: 0.74-0.87) and 0.83 (95% CI: 0.78-0.87), respectively. FDG-PET and FDG-PET/CT can detect primary tumors that went undetected by physical examination and conventional workup. FDG-PET exhibited lower sensitivity with respect to the tumors at the base of the tongue and the tonsils.

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Reverse Ventilation-Perfusion Mismatch

Cited by 10 publications

References 0 publications

<p>Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis</p>

<p>Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis</p>

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Role of fluorodeoxyglucose-PET versus fluorodeoxyglucose-PET/computed tomography in detection of unknown primary tumor: a meta-analysis of the literature

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