Tuberc Respir Dis.  1990 Mar;37(1):36-44. 10.4046/trd.1990.37.1.36.

Application of Perfusion Lung Scan for the Prediction of Pulmonary Function after the Lung Resection

Abstract

A preoperative prediction of postoperative pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. Surgery is the most effective therapy for carcinoma of the lung and offers the best rate of survival of the lung has coexisting chronic obstructive pulmonary disease. which may be so severe that resectional surgery may not be tolerate. There are several methods to predict postoperative pulmonary function but these techniques require specialized equipment and skilled personnel and are not readily available to most physicians. We studied the accuracy of the perfusion lung scan using 99 m technetium macroaggregated albumin (M.A.A.) in predicting postoperative lung function on 36 patients who received either pneumonectomy (1 6 patients) or lobectomy (20 patients). We performed the perfusion lung scan and combined with pulmonary lung function (FVC, FEV l, FEF 25%- 75% . MVV) to predict postoperative pulmonary lung function. We compared this predicted value to actually measured pulmonary function. which was done 3 months after the surgery. The results were as follows: 1) The correlation coefficient between the predicted and measured value of FEVl was 0.91 (p<0.01), FEF 25%-75% 0.86 (p<0.01), MVV 0. 87 (p < 0.01) and FVC 0.78 (p<0.01). 2) In pneumonectomy group. the correlation coefficient between the predicted and measured vallle of FEVl was 0.91 (p<0.01). MVV 0.88 (p<0.0 1). FEF 25%-75% 0.84 (p <0.01) and FVC 0.79 (p< 0.0 1). In lobectomy group. the correlation coefficient between the predicted and measured Values of FEVl and FEF 25%-75% were 0. 90 (p<0.01), MVV 0.85 (p<0.01), and FVC0.75 (p< (0.01) There was no significant difference between pneumonectomy group and lobectomy group in the prediction of pulmonaη function In conclusion, the perfusion lung scan is non-invasive and very accurate for predicting postresectional pulmonary function and the correlation of FEVl between predicted and measured value was highest. And there was no significant difference between pneumonctomy and lobectomy group in the prediction of pulmonary function.

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