[Evaluation of thrombolytic therapy by pulmonary radionuclide perfusion imaging in patients with acute pulmonary thromboembolism].
OBJECTIVE
To assess the change of pulmonary perfusion after thrombolytic therapy in patients with acute pulmonary embolism.


METHODS
Eighty patients with acute pulmonary embolism received pulmonary radionuclide perfusion imaging before and after thrombolytic therapy. Percentage of perfusion defect scores (PPDs) was calculated by semiquantitative analysis of pulmonary perfusion imaging before thrombolytic therapy (PPDsD(0)), 1 - 5 days (PPDsD(5)), 6 - 30 days (PPDsD(30)) and 3 months after thrombolytic therapy (PPDsM(3)).


RESULTS
The mean PPDsD(0) of the 80 patients was (57.3 +/- 16.4)%. In 64 of the 80 patients, mean PPDsD(0) and PPDsD(5) were (55.5 +/- 16.8)% and (40.0 +/- 18.6)% respectively (P < 0.001). In 30 of these 64 patients, mean PPDsD(0), PPDsD(5) and PPDsD(30) were (57.5 +/- 16.1)%, (39.3 +/- 16.8)% and (29.5 +/- 17.3)% respectively. Differences between these 3 mean PPDs values were highly significant (all P < 0.001). In 11 of the 80 patients, mean PPDsD(30) and PPDsM(3) were (40.9 +/- 18.1)% and (29.1 +/- 27.1)% respectively (P < 0.05). In two groups of patients with the courses of disease in 7 days and in 8 - 14 days respectively, significant differences were found between PPDsD(0) and PPDsD(5) (P < 0.001, P < 0.001 respectively), and between PPDsD(0) and PPDsD(30) (P < 0.001, P < 0.005 respectively). The difference was also significant, although to a lesser degree (P < 0.05) between these values in a group of patients with the course of disease beyond 14 days.


CONCLUSIONS
This study suggests that radionuclide pulmonary perfusion imaging is a reliable method for evaluating the changes of pulmonary perfusion before and after thrombolytic therapy in patients with acute pulmonary embolism.
Fang
Wei
W
Fuwai Cardiovascular Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China.
Shi
Rong-fang
RF
Liu
Xiu-jie
XJ
Cheng
Xian-sheng
XS
Chen
Bai-ping
BP
Liu
Zhi-hong
ZH
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins / Q000627:therapeutic use; D013668:Technetium Tc 99m Aggregated Albumin; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D014692:Ventilation-Perfusion Ratio
D005343:Fibrinolytic Agents; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013668:Technetium Tc 99m Aggregated Albumin; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator