Diagnostic value of ventilation/perfusion single-photon emission computed tomography/computed tomography for bronchiolitis obliterans syndrome in patients after lung transplantation

Abstract

To evaluate the diagnostic value of function volume/morphological volume ratio calculated from ventilation/perfusion single-photon emission computed tomography/computed tomography in distinguishing the lungs with bronchiolitis unilateral lungs were significantly lower in lungs with bronchiolitis obliterans syndrome (each P < 0.0001). The area under the curve values of ventilation and perfusion images were 0.97 and 0.99, respectively. Significant correlations were identified between the function volume/morphological volume ratios of ventilation and perfusion images and forced expiratory volume in 1 second (r = 0.54, P < 0.0001 and r = 0.45, P < 0.0001, respectively). The function volume/morphological volume ratio of ventilation image had a significantly weak correlation with forced vital capacity. Conclusions The function volume/morphological volume ratio enables a semi-quantitative assessment of ventilation and perfusion lung functions and is useful for diagnosing bronchiolitis obliterans syndrome after lung transplantation.

Post-infectious Bronchiolitis Obliterans: HRCT, DECT, Pulmonary Scintigraphy Images, and Clinical Follow-up in Eight Children

“…The mosaic pattern may be caused by vascular shunt from hypo-ventilated areas to normal or hyper-ventilated areas with decreased perfusion due to vessel constriction caused by regional tissue hypoxia (22). To further understand the distribution of pulmonary blood flow, a V/Q scan can provide functional lung imaging to diagnose BO (33,34). In accordance with our previous study (11), decreased V/Q-matched defects were the major finding of pulmonary scintigraphy in the patients with BO in the current study.…”

Relative Lung Perfusion on Ventilation–Perfusion Scans After Double Lung Transplant

“…Although VQ scans are most often used to diagnose pulmonary thromboembolism, they have recognized value in the posttransplant evaluation of recipients, including detecting changes that may predate the decline in spirometry that is the hallmark of chronic lung allograft dysfunction (CLAD). 2-4…”

“…Although VQ scans are most often used to diagnose pulmonary thromboembolism, they have recognized value in the posttransplant evaluation of recipients, including detecting changes that may predate the decline in spirometry that is the hallmark of chronic lung allograft dysfunction (CLAD). [2][3][4] Relative lung perfusion differential on VQ scans assesses the symmetry of pulmonary blood flow between the right and left lung and indirectly assesses ventilation because of the hypoxic pulmonary vasoconstriction response. 5 A right-to-left perfusion differential of <10% (55%-45%) is typically considered normal, but the physiologic correlates and prognostic associations of perfusion differentials have not been studied.…”