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目的:探讨慢性血栓栓塞性肺动脉高压(CTEPH)患者肺灌注SPECT/CT显像肺灌注体积及视觉评分与右心导管血流动力学参数的相关性。方法:回顾性分析2015年3月至2019年7月间广州医科大学附属第一医院51例连续CTEPH患者的资料，其中男17例，女34例，年龄(59±12)岁。所有患者均行肺灌注SPECT/CT显像及右心导管检查。应用不同百分比阈值(15%～85%)分割法计算肺灌注体积。参照Begic三分法对肺灌注SPECT/CT图像进行视觉评分。收集右心导管检查血液动力学参数[肺动脉收缩压(PASP)、舒张压(PADP)及平均压(mPAP)、肺小动脉楔压(PAWP)、肺血管阻力(PVR)、心输出量(CO)、心指数(CI)等]，并采用Spearman相关分析评价肺灌注体积、视觉评分和右心导管血流动力学参数间的相关性。结果:在30%～70%阈值下，双肺灌注体积与mPAP间存在相关性(n rs值：-0.414～-0.302，均n P<0.05)。其中40%和45%阈值下双肺灌注体积与mPAP间呈中等负相关(n rs值：-0.414和-0.412，均n P<0.05)。40%阈值下双肺灌注体积与PASP、PADP呈中等负相关(n rs值：-0.402和-0.440,均n P<0.05)，与PVR呈弱的负相关(n rs＝-0.352，n P<0.05)。视觉评分与PADP间存在弱的正相关(n rs＝0.311, n P0.05)。n 结论:肺灌注SPECT/CT显像中基于阈值分割的肺灌注体积参数可较准确反映肺动脉压力等血流动力学状态，可用于评估CTEPH患者病情严重程度。“,”Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP (n rs values: from -0.414 to -0.302, all n P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP (n rs values: -0.414, -0.412, both n P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP (n rs values: -0.402, -0.440, both n P<0.05), and slightly negatively correlated with PVR (n rs=-0.352, n P<0.05). Visual scores were slightly positively correlated with the PADP (n rs=0.311, n P0.05).n Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.