Pulmonary capillary wedge pressure, as inferred from lung areas in gated blood-pool scintigrams: concise communication.
To determine whether the apex-to-base distribution of pulmonary blood volume, as obtained from gated cardiac blood-pool scans, could be used as a noninvasive method to estimate mean pulmonary capillary wedge pressure (PCWP), gated blood-pool scans were analyzed in 77 patients who also had PCWP measurements at cardiac catheterization. Ten of these patients had gated cardiac blood-pool scans and PCWP measurements both at rest and during exercise. The apex-to-base distribution of pulmonary blood volume was determined from the end-systolic frame of the left anterior oblique view by placing equal-sized regions of interest over the apex and base of the right lung. The ratio of apex counts over base counts (A/B ratio) was considered abnormal if greater than unity. The mean A/B ratio was 1.15 +/- 0.27 (1 s.d.) for the 32 studies associated with an abnormal mean PCWP (greater than 12 mm Hg). The mean A/B ratio was 0.85 +/- 0.23 for the 55 studies associated with a normal mean PCWP (p less than 0.01 comparing normal group with abnormal). The sensitivity of the A/B ratio for a mean PCWP greater than 12 mm Hg was 81%R (26/32). The specificity of the A/B ratio for a mean PCWP greater than or equal to 12 mm Hg was 89% (49/55). Thus, noninvasive determination of the pulmonary apex-to-base ratio from gated cardiac blood-pool scans appears to differentiate subjects with normal and abnormal mean pulmonary capillary wedge pressures.
D000328:Adult; D000368:Aged; D001810:Blood Volume; D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011122:Polyphosphates; D011652:Pulmonary Circulation; D011669:Pulmonary Wedge Pressure; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate; D014003:Tin Polyphosphates
D011122:Polyphosphates; D014003:Tin Polyphosphates; C017742:technetium Tc 99m stannous pyrophosphate; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium