Objective analysis of whole lung and lobar ventilation/perfusion relationships in pulmonary embolism

被引：16

作者：

Harris, Benjamin ^{[1
,2
,3
]}

Bailey, Dale L. ^{[3
,4
,5
]}

Chicco, Peter ^{[6
]}

Bailey, Elizabeth A. ^{[4
]}

Roach, Paul J. ^{[4
]}

King, Gregory G. ^{[1
,2
,3
]}

机构：

[1] Royal N Shore Hosp, Dept Resp Med, Sydney, NSW 2065, Australia

[2] Univ Sydney, Fac Med, No Clin Sch, Sydney, NSW 2006, Australia

[3] Woolcock Inst Med Res, Sydney, NSW, Australia

[4] Royal N Shore Hosp, Dept Nucl Med, Sydney, NSW, Australia

[5] Univ Sydney, Sch Med Radiat Sci, Sydney, NSW 2006, Australia

[6] Royal N Shore Hosp, Dept Biomed Engn, Sydney, NSW, Australia

来源：

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING | 2008年 / 28卷 / 01期

关键词：

image processing; pulmonary embolism; SPECT; V/Q;

D O I：

10.1111/j.1475-097X.2007.00767.x

中图分类号：

Q4 [生理学];

学科分类号：

071003 [生理学];

摘要：

Purpose: Lung scintigraphy using single photon emission computed tomography (SPECT) allows accurate regional measurement of the ventilation/perfusion ((V) over dot/(Q) over dot) relationship. Objective alysis has been shown to be useful in the diagnosis of pulmonary embolism (PE). By using anatomical information provided by co-registered computed tomography, we describe methodology for determining the extent of ((V) over dot/(Q) over dot) heterogeneity at a lobar level. We investigate this methodology using simulated data, and demonstrate its potential application in the clinical setting of PE. Methods: Data representing an incremental perfusion defect involving the right lung, together with an unaffected ventilation dataset, were modelled using Monte Carlo simulation. For each increase in the size of the perfusion defect, the whole lung ((V) over dot/(Q) over dot) relationship was objectively determined. In addition, using an image mask of the pulmonary lobes, lobar ((V) over dot/(Q) over dot) relationships were also determined. ((V) over dot/(Q) over dot) heterogeneity was characterized using the log(10) standard deviation of the ((V) over dot/(Q) over dot) ratio (log SDVQR), ventilation (log SDV) and perfusion (log SDQ) distributions. Finally, this methodology was explored in clinical cases. Results: As an increasing number of segments were involved by perfusion defects, there was a progressive increase in all objective parameters of ((V) over dot/(Q) over dot) heterogeneity. The relative change was greatest for log SDV. Analysis of both the simulated and clinical studies demonstrated sensitive changes in the lobar ((V) over dot/(Q) over dot) profiles to the presence of PE. Conclusions: Segmentation and analysis of SPECT ventilation-perfusion scintigraphy at a lobar level can be used to quantify regional ((V) over dot/(Q) over dot) relationships. This objective methodology is sensitive to the presence of PE, and may be useful in a clinical setting.

引用

页码：14 / 26

页数：13

共 46 条

[1]

Pulmonary embolization causes hypoxemia by redistributing regional blood flow without changing ventilation [J].