Pulmonary involvement in Behcet’s disease: Definition of Tc99m-MAA lung scintigraphy perfusion patterns according to the affected pulmonary vascular levels

Authors : Sibel UÇAK SEMİRGİN, Oguz UZUN

Pages : 29-35

View : 33 | Download : 10

Publication Date : 2020-04-06

Article Type : Research Paper

Abstract :The aim of this study was to define lung perfusion scintigraphy findings in Behcet’s disease insert ignore into journalissuearticles values(BD); patients with different variations of pulmonary involvement. Medical records and imaging findings of 23 patients with pulmonary involvement of BD were retrospectively reviewed. Before scintigraphic evaluation, patients were classified according to the affected pulmonary vascular level on CT angiography insert ignore into journalissuearticles values(CTA); as follows: Macroscopic pulmonary vascular involvement insert ignore into journalissuearticles values(Gr-1); [Pulmonary artery aneurysm without thrombosis insert ignore into journalissuearticles values(Gr-1a);, pulmonary artery aneurysm with thrombosis insert ignore into journalissuearticles values(Gr-1b);, pulmonary artery thrombosis without aneurysm insert ignore into journalissuearticles values(Gr-1c);]; microscopic pulmonary vascular involvement insert ignore into journalissuearticles values(Gr-2; no macroscopic CTA findings but with clinical diagnosis and/or scintigraphic abnormality);. There were 18 patients in Gr-1 and five patients in Gr-2. Segmental/subsegmental perfusion defects were the most common perfusion pattern and no distinctive pattern was observed among all groups. In 12 patients with macroscopic disease and two patients with microscopic disease, perfusion defects were more extensive than involved vessels on CTA and/or also in the contralateral lung. There were 13 patients with scintigraphic follow-up findings. No change was observed in all Gr-1b and Gr-2 patients; there were heterogeneous changes in 6/7 patients in Gr-1c. No typical perfusion pattern could be demonstrated for a given macroscopic vascular category. In patients with microscopic disease, similarly no characteristic pattern could be defined. As almost all patients with microscopic disease showed perfusion anomalies, scintigraphy may be proposed as a first step examination in case of suspected pulmonary involvement in BD. Scintigraphic follow-up may be of value in pure thrombotic pulmonary involvement.
Keywords : Behcets disease, lung perfusion, scintigraphy, CT angiography

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