Diagnosis of chronic thromboembolic pulmonary hypertension: comparison of ventilation/perfusion scanning and multidetector computed tomography pulmonary angiography with pulmonary angiography

Nucl Med Commun. 2012 May;33(5):459-63. doi: 10.1097/MNM.0b013e32835085d9.


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.

Conclusion: In conclusion, both V/Q scanning and CTPA are accurate methods for the detection of CTEPH with excellent diagnostic efficacy.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Gamma Cameras
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Prospective Studies
  • Pulmonary Embolism / diagnostic imaging*
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Technetium Tc 99m Aggregated Albumin
  • Ventilation-Perfusion Ratio


  • Radiopharmaceuticals
  • Technetium Tc 99m Aggregated Albumin