title: A non-invasive, quantitative method to demonstrate the early effects of therapy in acute pulmonary embolism.
abstract: The objective of this study was to quantify the changes in pulmonary perfusion due to therapy for pulmonary embolism (PE). To this end, seven consecutive patients (five men, two women; mean age 64+/-10 years) were studied. After basal pulmonary arteriography had demonstrated the presence of massive PE, patients were injected intravenously with 4 mCi of technetium-99m-labelled human albumin microspheres and were treated soon thereafter with a 2-h infusion of either alteplase 100 mg (five patients) or heparin 1,750 IU/h (two patients). Then, a second pulmonary arteriography study was obtained, and soon afterwards a single-photon emission tomographic (SPET) perfusion scan was performed. Immediately thereafter, a second intravenous injection of 4 mCi of 99mTc-labelled microspheres was administered, followed by a second SPET scan. At the end of the study, the perfusion changes due to therapy were quantified by subtraction of the images of the two SPET studies; the reperfused areas could be visualised and the volumes of reperfusion quantified. This study demonstrates the validity of a newly devised, relatively rapid and non-invasive method for quantification of the early effects of therapy on pulmonary perfusion in patients presenting with acute PE.
authors.affiliation: Cardiac and Thoracic Department, University of Pisa, Ospedale Cisanello, Via Paradisa, 2-56124 Pisa, Italy. a.palla@med.unipi.it
authors.forename: A
authors.initials: A
authors.lastname: Palla
authors.forename: C R
authors.initials: CR
authors.lastname: Bellina
authors.forename: C
authors.initials: C
authors.lastname: Marini
authors.forename: M
authors.initials: M
authors.lastname: Pazzagli
authors.forename: C
authors.initials: C
authors.lastname: Giuntini
mesh_terms: D000208:Acute Disease; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011859:Radiography; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005343:Fibrinolytic Agents; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D006493:Heparin; D010959:Tissue Plasminogen Activator