摘要
目的评价放射性核素肺通气/灌注(V/Q)显像在急性肺血栓栓塞症(PTE)诊断中的价值及国人肺动脉血栓栓塞后肺血流灌注受损情况和受累肺段、肺叶的分布特点。方法采用前瞻性描述性研究方法,将明确诊断为PTE的519例患者分为大面积、次大面积PTE组(249例)和非大面积(不含次大面积)PTE组(270例)。对519例急性PTE患者均进行了肺V/Q显像,其中有773例次与CT肺动脉造影(CTPA)结果进行了对比分析。结果在治疗前行肺V/Q显像和CTPA的PTE患者中,PTE的总检出率分别为93．3%和89．3%(P＞0．05);急性大面积和次大面积PTE组的检出率分别为86．9%和100%(P＜0．001);急性非大面积PTE组的检出率分别为98．2%和77．5%(P＜0．001)。肺V/Q显像示病变分布的特点为:右肺多于左肺,下叶多于上叶,背段多于前段。肺V/Q显像与CTPA的符合率比较:肺高于肺叶,肺叶高于肺段,溶栓组高于抗凝组。结论肺V/Q显像在急性PTE的诊断中具有重要的作用和独特的价值,与CTPA联合应用,可起到决定性的诊断作用。PTE患者肺内血栓的分布特点符合“浓度守衡定律”。
Objective The radionuclide pulmonary ventilation-perfusion （V/Q） imaging was proven useful in the diagnosis of acute pulmonary thromboembolism （PTE）. The aim of the current study was to use V/Q imaging to assess the impaired states of the lung blood flow and the distributive characteristics of the damaged lung segments and lung lobes in PTE. Methods All 519 patients with acute PTE were included in the current multi-center randomized study, with 249 massive and sub-massive PTE and 270 non-massive PTE. All 519 patients underwent pulmonary V/Q imaging. Of 519 patients with pulmonary V/Q imaging, 773 scans were compared with the findings of spiral CT pulmonary arteriography （CTPA）. Results Before treatment, the total detection rates of PTE with pulmonary V/Q imaging and CTPA were 93.3% and 89.3% （P 〉0.05 ） , the detection rates of massive and sub-massive PTE were 86.9% and 100% （ P 〈 0.01 ） ; and the detection rates of non-massive PTE were 98.2% and 77.5% respectively （ P 〈 0. 001 ）. In pulmonary V/Q imaging, the defects in the right lung, lower lobe and superior segment were more likely affected than that in the left. Conclusion Radionuclide pulmonary V/Q imaging plays an important and special role in the diagnosis of acute PTE. The combination of pulmonary V/Q imaging and CTPA can be a crucial diagnostic approach. The thrombotic distribution in the lung of PTE patients is in accordant with ＂concentration conservation law＂.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2006年第6期330-333,共4页
Chinese Journal of Nuclear Medicine
基金
"十五"国家科技攻关计划项目资助(2004BA703B07)
关键词
肺栓塞
放射性核素显像
锝
MAA
Pulmonary embolism
Radionuclide imaging
Technetium
MAA
