Abstract
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Objectives We previously presented that non-segmental peripheral patchy decrease (NSPPD) of 99mTc-MAA lung scintigraphy using SPECT/CT might indicate the possibility of pulmonary hypertension (PH) at the meeting of SNMMI 2012 and 2014. We aim to investigate the findings of 99mTc-MAA scintigraphy in patients diagnosed as PH caused by various diseases.
Methods Fifty patients who had been diagnosed as PH before and/or after performing 99mTc-MAA scintigraphy using SPECT/CT were evaluated (chronic thromboembolic pulmonary hypertension (CTEPH) 14, idiopathic pulmonary arterial hypertension 6, pulmonary embolism 1, interstitial pneumonia 1, emphysema 1, collagen disease 14, right heart failure 1, left heart failure 10, portal hypertension 1, anomalous pulmonary venous return 1). Pulmonary artery pressure by echocardiography, right heart catheterization, and medical record are retrospectively analyzed.
Results Non-segmental peripheral severe perfusion decrease (NSPSPD) was observed in 13 patients with CTEPH, however NSPSPD was not found in patients with PH except CTEPH. One patient with CTEPH had segmental multiple defects in bilateral lungs without the sign of NSPSPD. NSPPD was observed in 27 out of 36 patients with PH except CTEPH (collagen disease 10, left heart failure 9, idiopathic pulmonary arterial hypertension 2, interstitial pneumonia 1, interstitial pneumonia 1, emphysema 1, right heart failure 1, portal hypertension 1, anomalous pulmonary venous return 1). The upper lung field predominant pulmonary perfusion was observed in 9 patients, adding to NSPPD or NSPSPD (CTEPH 3, collagen disease 2, right heart failure 1, left heart failure 3). Four patients had only heterogeneous distribution of pulmonary perfusion in bilateral lungs without the sign of NSPPD nor NSPSPD (idiopathic pulmonary arterial hypertension 1, collagen disease 2, left heart failure 1), and 5 patients had no apparent signs of abnormality (idiopathic pulmonary arterial hypertension 3, collagen disease 2).
Conclusions We suggest that NSPPD of pulmonary perfusion scan using SPECT/CT could indicate the presence of pulmonary hypertension and that NSPSPD should be considered as the sign indicating CTEPH and could be useful for the diagnosis of CTEPH differentiated from PH caused by other diseases.
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