A non-invasive, quantitative method to demonstrate the early effects of therapy in acute pulmonary embolism.
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.
Palla
A
A
Cardiac and Thoracic Department, University of Pisa, Ospedale Cisanello, Via Paradisa, 2-56124 Pisa, Italy. a.palla@med.unipi.it
Bellina
C R
CR
Marini
C
C
Pazzagli
M
M
Giuntini
C
C
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
D005343:Fibrinolytic Agents; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D006493:Heparin; D010959:Tissue Plasminogen Activator