Compare the value of ventilation/perfusion scanning and CT pulmonary angiography in predicting chronic thromboembolic pulmonary hypertension after acute pulmonary embolism
Compare the value of ventilation/perfusion scanning and CT pulmonary angiography in predicting chronic thromboembolic pulmonary hypertension after acute pulmonary embolism
Objective:To compare the value of lung ventilation/perfusion(V/Q)scanning and CT pulmonary angiography(PA)in predicting chronic thromboembolic pulmonary hypertension(CTEPH)development after acute pulmonary embolism(APE).Methods:From January 2012 to August 2020,patients with initial diagnosis of APE who undergone both lung V/Q and CTPA after 3-month anticoagulation were retrospected.The residual pulmonary obstructions were assessed and calculated based on V/Q and CTPA,then recorded as percentage of pulmonary defect scores(PPDs％)and CT pulmonary artery obstruction index(PAOI).The uniformity of PPDs％and CTPAOI in predicting CTEPH was evaluated.The predictive performance of PPDs％and CTPAOI for CTEPH development were determined by receiver operating characteristic(ROC)curves,and the areas under the curves(AUC)were calculated.Results:A total of 224 patients were enrolled.Within the 1-year follow-up,26 patients developed to CTEPH.Bland-Altman plot shows uniformity of residual pulmonary embolism between PPDs％and CTPAOI was better.ROC analysis showed that the AUC of the PPDs％were largerthan that of CTPAOI(0.958 vs.0.868,P=0.03),with corresponding cut-off values of 20.5％and 15.0％for predicting CTEPH development.Neither sensitivity nor specificity differed significantly between PPDs％and CTPAOI(Sensitivity:92.3％vs.88.9％,P=0.13;Specificity:76.9％vs.89.4％,P＞0.999).Conclusions:V/Qscanning has a tendency to be more sensitive but less specific than CT PA in predicting CTEPH development.
维普
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