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Quantitative Analysis of Lung Perfusion in Patients with Primary Pulmonary Hypertension

¹ Department of Radiology, National Cardiovascular Center, Suita, Osaka, Japan
² Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan

The aim of this study was to evaluate quantitatively the heterogeneity of lung perfusion scans in patients with primary pulmonary hypertension (PPH) and to compare it with the severity of disease. Methods: Lung perfusion scans were obtained on 22 patients with PPH and 12 age-matched control subjects. The perfused area rates (PARs) were calculated by dividing the lung area in each 10% threshold width from 10% to 100% of maximal counts by total lung area. The total absolute difference in the PAR between each patient and the mean control value was assumed as the perfusion index of the lung (P index). The P index was compared with hemodynamic parameters and the right ventricular ejection fraction (RVEF), including 7 patients who received long-term vasodilator therapy. Results: The P index correlated significantly with mean pulmonary arterial pressure (P < 0.001) and RVEF (P < 0.05). In patients with vasodilator therapy, the P index was improved significantly after therapy (P < 0.05) and was associated with a reduction in pulmonary arterial pressure. Conclusion: Quantitative assessment of lung perfusion irregularity might provide useful information about the severity of disease and the effect of therapy in addition to the routine visual representation.

Key Words: lung perfusion scan • primary pulmonary hypertension • ^99mTc-labeled macroaggregated albumin

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