Pulmonary capillary wedge pressure, as inferred from lung areas in gated blood-pool scintigrams: Concise communication

A. Urbina, R. D. Okada, I. Palacios, M. Osbakken, H. W. Strauss

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Abstract

To determine whether the apex-to-base distribution of pulmonary blood volume, as obtained from gated cardiac blood-pool scans, could be used as a noninvasive method to estimate mean pulmonary capillary wedge pressure (PCWP), gated blood-pool scans were analyzed in 77 patients who also had PCWP measurements at cardiac catheterization. Ten of these patients had gated cardiac blood-pool scans and PCWP measurements both at rest and during exercise. The apex-to-base distribution of pulmonary blood volume was determined from the end-systolic frame of the left anterior oblique view by placing equal-sized regions of interest over the apex and base of the right lung. The ratio of apex counts over base counts (A/B ratio) was considered abnormal if greater than unity. The mean A/B ratio was 1.15 ± 0.27 (1 s.d.) for the 32 studies associated with an abnormal mean PCWP (greater than 12 mm Hg). The mean A/B ratio was 0.85 ± 0.23 for the 55 studies associated with a normal mean PCWP (p < 0.01 comparing normal group with abnormal). The sensitivity of the A/B ration for a mean PCWP > 12 mm Hg was 81% (26/32). The specificity of the A/B ratio for a mean PCWP > 12 mm Hg was 89% (49/55). Thus, noninvasive determination of the pulmonary apex-to-base ratio from gated cardiac blood-pool scans appears to differentiate subjects with normal and abnormal mean pulmonary capillary wedge pressures.

Original languageEnglish
Pages (from-to)950-954
Number of pages5
JournalJournal of Nuclear Medicine
Volume22
Issue number11
StatePublished - 1981

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