Source: Annual Congress 2008 - Diagnosis of tuberculosis: problems and perspectives

Abstract

Aim. To study ventilation-perfusion ratio (V/Q), apex-base gradient of perfusion (U/L-Q) and ventilation (U/L-V), alveolar-capillary permeability (ACP) in patients with infiltrative pulmonary tuberculosis (IPTB) according to the data received from nuclear medicine study.
Materials and methods. 30 patients with pulmonary tuberculosis underwent ventilation-perfusion pulmonoscintigraphy: 20 patients with IPTB and 10 healthy volunteers (control group). The study focused on V/Q, U/L-Q, U/L-V, and ACP according to the dynamics of radiopharmaceutical derivation during the 1st, 10th and 30th minutes after DTPA (Omega 500 gamma camera, Technicare, USA-Germany).
Results. V/Q in the damaged lung of IPTB patients (0,98±0,06) was similar to that of control group (p=0,76), and it was higher (1,03±0,06) in the intact lung (p=0,03). U/L-Q (0,65±0,10) in the damaged lung was similar to that of control group (p=0,3), and it was higher (0,60±0,10) in the intact lung (p=0,04). There was no difference of U/L-V in the damaged lung between IPTB patients (0,63±0,10) and control group (p=0,4), and it was increased in the intact lung (0,70±0,10) (p=0,04). ACP in IPTB patients during 30th minute of the study was elevated both in the damaged (27,9±5,8%) and intact lung (27,5±4,6%) compared to ACP in control group (p=0,03, p=0,04, respectively).
Conclusions. IPTB patients have increased V/Q, U/L-Q and U/L-V in the intact lung. The increased ACP in both the damaged and intact lungs is documented during 30th minute of the study. The study findings may serve as a supplementary diagnostic sign of infiltrative pulmonary tuberculosis.

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N. G. Krivonogov, S. P. Mishustin, T. S. Ageeva, E. L. Mishustina, A. V. Dubodelova (Tomsk, Russian Federation). Ventilation-perfusion pulmonoscintigraphy in diagnosis of pulmonary tuberculosis. Eur Respir J 2008; 32: Suppl. 52, 2379

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