Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach
Background & Aims: We have reported that contrast echocardiography is a sensitive screening test for the hepatopulmonary syndrome (HPS). However, contrast echocardiography lacks specificity because many cirrhotic patients have positive study results with normal arterial blood gases and therefore...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1998-02, Vol.114 (2), p.305-310 |
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| container_title | Gastroenterology (New York, N.Y. 1943) |
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| creator | Abrams, Gary A. Nanda, Navin C. Dubovsky, Eva V. Krowka, Michael J. Fallon, Michael B. |
| description | Background & Aims: We have reported that contrast echocardiography is a sensitive screening test for the hepatopulmonary syndrome (HPS). However, contrast echocardiography lacks specificity because many cirrhotic patients have positive study results with normal arterial blood gases and therefore do not fulfill criteria for HPS. The aim of this study was to assess the role of macroaggregated albumin lung perfusion scans (MAA scans) in the diagnosis of HPS.
Methods: MAA scans were performed in 25 patients with HPS, 25 cirrhotic patients without HPS, and 15 hypoxemic subjects with intrinsic lung disease alone. An MAA shunt fraction was calculated from brain and lung counts.
Results: MAA scan results were positive in 21 of 25 patients with HPS and negative in all controls. All 21 patients with positive MAA scans had P
O
2 values of |
| doi_str_mv | 10.1016/S0016-5085(98)70481-0 |
| format | Article |
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Methods: MAA scans were performed in 25 patients with HPS, 25 cirrhotic patients without HPS, and 15 hypoxemic subjects with intrinsic lung disease alone. An MAA shunt fraction was calculated from brain and lung counts.
Results: MAA scan results were positive in 21 of 25 patients with HPS and negative in all controls. All 21 patients with positive MAA scans had P
O
2 values of <60 mm Hg. There was a strong inverse correlation between the degree of the MAA shunt fraction and arterial hypoxemia (
r = −0.726).
Conclusions: A positive MAA scan result in cirrhosis is specific for the presence of moderate to severe HPS. We speculate that MAA scans may be particularly useful in evaluating the contribution of HPS to the hypoxemia in cirrhotic patients with intrinsic lung disesase.
GASTROENTEROLOGY 1998;114:305-310</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1016/S0016-5085(98)70481-0</identifier><identifier>PMID: 9453490</identifier><identifier>CODEN: GASTAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Brain - blood supply ; Brain - diagnostic imaging ; Dilatation, Pathologic - diagnostic imaging ; Dilatation, Pathologic - etiology ; Female ; Humans ; Hypoxia - diagnostic imaging ; Hypoxia - etiology ; Hypoxia - physiopathology ; Investigative techniques, diagnostic techniques (general aspects) ; Liver Cirrhosis - complications ; Lung - blood supply ; Lung - diagnostic imaging ; Lung Diseases - diagnostic imaging ; Lung Diseases - etiology ; Lung Diseases - physiopathology ; Male ; Medical sciences ; Middle Aged ; Pulmonary Gas Exchange ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radionuclide Imaging ; Radiopharmaceuticals ; Respiratory system ; Sensitivity and Specificity ; Syndrome ; Technetium Tc 99m Aggregated Albumin</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 1998-02, Vol.114 (2), p.305-310</ispartof><rights>1998 American Gastroenterological Association</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-4bf073ecb72fd6bc3abeaa5842452d7854a36bae333e670a9817e7880c34f7a93</citedby><cites>FETCH-LOGICAL-c488t-4bf073ecb72fd6bc3abeaa5842452d7854a36bae333e670a9817e7880c34f7a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016508598704810$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2140271$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9453490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abrams, Gary A.</creatorcontrib><creatorcontrib>Nanda, Navin C.</creatorcontrib><creatorcontrib>Dubovsky, Eva V.</creatorcontrib><creatorcontrib>Krowka, Michael J.</creatorcontrib><creatorcontrib>Fallon, Michael B.</creatorcontrib><title>Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Background & Aims: We have reported that contrast echocardiography is a sensitive screening test for the hepatopulmonary syndrome (HPS). However, contrast echocardiography lacks specificity because many cirrhotic patients have positive study results with normal arterial blood gases and therefore do not fulfill criteria for HPS. The aim of this study was to assess the role of macroaggregated albumin lung perfusion scans (MAA scans) in the diagnosis of HPS.
Methods: MAA scans were performed in 25 patients with HPS, 25 cirrhotic patients without HPS, and 15 hypoxemic subjects with intrinsic lung disease alone. An MAA shunt fraction was calculated from brain and lung counts.
Results: MAA scan results were positive in 21 of 25 patients with HPS and negative in all controls. All 21 patients with positive MAA scans had P
O
2 values of <60 mm Hg. There was a strong inverse correlation between the degree of the MAA shunt fraction and arterial hypoxemia (
r = −0.726).
Conclusions: A positive MAA scan result in cirrhosis is specific for the presence of moderate to severe HPS. We speculate that MAA scans may be particularly useful in evaluating the contribution of HPS to the hypoxemia in cirrhotic patients with intrinsic lung disesase.
GASTROENTEROLOGY 1998;114:305-310</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brain - blood supply</subject><subject>Brain - diagnostic imaging</subject><subject>Dilatation, Pathologic - diagnostic imaging</subject><subject>Dilatation, Pathologic - etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoxia - diagnostic imaging</subject><subject>Hypoxia - etiology</subject><subject>Hypoxia - physiopathology</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Liver Cirrhosis - complications</subject><subject>Lung - blood supply</subject><subject>Lung - diagnostic imaging</subject><subject>Lung Diseases - diagnostic imaging</subject><subject>Lung Diseases - etiology</subject><subject>Lung Diseases - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pulmonary Gas Exchange</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Respiratory system</subject><subject>Sensitivity and Specificity</subject><subject>Syndrome</subject><subject>Technetium Tc 99m Aggregated Albumin</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE9P3DAQxS3UCpYtHwHJh6oqh7R27MROLwihApWQemg5WxNnEowSO7UTKr59Dbvaay8zh_fe_PkRcs7ZF854_fUXy7WomK4-N_pCMal5wY7IhlelLrJWviObg-WEnKb0xBhrhObH5LiRlZAN25DhISENPZ3AxgDDEHGABTsKY7tOztNx9QOdMfZrcsHTZMHTJdDOweBDjj7iDEuY13EKHuILTS--i2HCb_SKevxLYZ7zXPv4gbzvYUx4tu9b8nDz_ff1XXH_8_bH9dV9YaXWSyHbnimBtlVl39WtFdAiQKVlKauyU7qSIOoWUAiBtWLQaK5Qac2skL2CRmzJp93cvPbPimkxk0sWxxE8hjUZ1dS15jm-JdXOmP9OKWJv5uim_ILhzLwCNm-AzSs902jzBtiwnDvfL1jbCbtDak806x_3OmRYYx_BW5cOtpJLViqebZc7G2YYzw6jSdaht9i5iHYxXXD_OeQfi5qYxw</recordid><startdate>19980201</startdate><enddate>19980201</enddate><creator>Abrams, Gary A.</creator><creator>Nanda, Navin C.</creator><creator>Dubovsky, Eva V.</creator><creator>Krowka, Michael J.</creator><creator>Fallon, Michael B.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980201</creationdate><title>Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach</title><author>Abrams, Gary A. ; Nanda, Navin C. ; Dubovsky, Eva V. ; Krowka, Michael J. ; Fallon, Michael B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-4bf073ecb72fd6bc3abeaa5842452d7854a36bae333e670a9817e7880c34f7a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brain - blood supply</topic><topic>Brain - diagnostic imaging</topic><topic>Dilatation, Pathologic - diagnostic imaging</topic><topic>Dilatation, Pathologic - etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoxia - diagnostic imaging</topic><topic>Hypoxia - etiology</topic><topic>Hypoxia - physiopathology</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Liver Cirrhosis - complications</topic><topic>Lung - blood supply</topic><topic>Lung - diagnostic imaging</topic><topic>Lung Diseases - diagnostic imaging</topic><topic>Lung Diseases - etiology</topic><topic>Lung Diseases - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pulmonary Gas Exchange</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Respiratory system</topic><topic>Sensitivity and Specificity</topic><topic>Syndrome</topic><topic>Technetium Tc 99m Aggregated Albumin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abrams, Gary A.</creatorcontrib><creatorcontrib>Nanda, Navin C.</creatorcontrib><creatorcontrib>Dubovsky, Eva V.</creatorcontrib><creatorcontrib>Krowka, Michael J.</creatorcontrib><creatorcontrib>Fallon, Michael B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abrams, Gary A.</au><au>Nanda, Navin C.</au><au>Dubovsky, Eva V.</au><au>Krowka, Michael J.</au><au>Fallon, Michael B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>1998-02-01</date><risdate>1998</risdate><volume>114</volume><issue>2</issue><spage>305</spage><epage>310</epage><pages>305-310</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><coden>GASTAB</coden><abstract>Background & Aims: We have reported that contrast echocardiography is a sensitive screening test for the hepatopulmonary syndrome (HPS). However, contrast echocardiography lacks specificity because many cirrhotic patients have positive study results with normal arterial blood gases and therefore do not fulfill criteria for HPS. The aim of this study was to assess the role of macroaggregated albumin lung perfusion scans (MAA scans) in the diagnosis of HPS.
Methods: MAA scans were performed in 25 patients with HPS, 25 cirrhotic patients without HPS, and 15 hypoxemic subjects with intrinsic lung disease alone. An MAA shunt fraction was calculated from brain and lung counts.
Results: MAA scan results were positive in 21 of 25 patients with HPS and negative in all controls. All 21 patients with positive MAA scans had P
O
2 values of <60 mm Hg. There was a strong inverse correlation between the degree of the MAA shunt fraction and arterial hypoxemia (
r = −0.726).
Conclusions: A positive MAA scan result in cirrhosis is specific for the presence of moderate to severe HPS. We speculate that MAA scans may be particularly useful in evaluating the contribution of HPS to the hypoxemia in cirrhotic patients with intrinsic lung disesase.
GASTROENTEROLOGY 1998;114:305-310</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9453490</pmid><doi>10.1016/S0016-5085(98)70481-0</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Brain - blood supply Brain - diagnostic imaging Dilatation, Pathologic - diagnostic imaging Dilatation, Pathologic - etiology Female Humans Hypoxia - diagnostic imaging Hypoxia - etiology Hypoxia - physiopathology Investigative techniques, diagnostic techniques (general aspects) Liver Cirrhosis - complications Lung - blood supply Lung - diagnostic imaging Lung Diseases - diagnostic imaging Lung Diseases - etiology Lung Diseases - physiopathology Male Medical sciences Middle Aged Pulmonary Gas Exchange Radiodiagnosis. Nmr imagery. Nmr spectrometry Radionuclide Imaging Radiopharmaceuticals Respiratory system Sensitivity and Specificity Syndrome Technetium Tc 99m Aggregated Albumin |
| title | Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: A new approach |
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