title: Diagnosis of chronic thromboembolic pulmonary hypertension:  comparison of ventilation/perfusion scanning and multidetector computed tomography pulmonary angiography with pulmonary angiography.
abstract: OBJECTIVE
  The correct and prompt diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) plays a pivotal role in determining appropriate therapy. This study aimed to compare the diagnostic efficacy of pulmonary ventilation/perfusion (V/Q) scanning and computed tomography pulmonary angiography (CTPA) using pulmonary angiography as the golden standard.
  
  
  METHODS
  A total of 114 consecutive patients (49 men and 65 women, age 43.3 ± 15.3 years) suspected of having CTEPH were prospectively enrolled. All patients underwent V/Q scanning, CTPA, and pulmonary angiography within an interval of 7 days from one another. Interpretation of V/Q images was based on the refined Pulmonary Embolism Diagnosis criteria. For threshold 1, high-probability and intermediate-probability V/Q scan findings were considered to be positive, and low-probability/normal V/Q scan findings were negative. For threshold 2, only a high-probability V/Q scan finding was considered to be positive, and intermediate-probability and low-probability/normal V/Q scan findings were considered to be negative.
  
  
  RESULTS
  Fifty-one patients (44.7%) had a final diagnosis of CTEPH. V/Q scan showed high probability, intermediate probability, and low probability/normal scan in 52, three, and 59 patients, respectively. CTPA revealed 50 patients with CTEPH and 64 patients without CTEPH. The sensitivity, specificity, and accuracy of the V/Q scan were 100, 93.7, and 96.5%, respectively, with threshold 1, and 96.1, 95.2, and 95.6%, respectively, with threshold 2; similarly, the sensitivity, specificity, and accuracy of CTPA were 92.2, 95.2, and 93.9%, respectively.
  
  
  CONCLUSIONS
  In conclusion, both V/Q scanning and CTPA are accurate methods for the detection of CTEPH with excellent diagnostic efficacy.
authors.affiliation: Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: He
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.forename: Bin
authors.initials: B
authors.lastname: Lv
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: He
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Xiong
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
authors.forename: Zuo-Xiang
authors.initials: ZX
authors.lastname: He
mesh_terms: D000328:Adult; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin; D014692:Ventilation-Perfusion Ratio
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin