肺通气/灌注显像与HCTPA诊断肺动脉栓塞的价值  

A comparative analysis of pulmonary ventilation-perfusion imaging with helical CT pulmonary angiography in the diagnosis of pulmonary embolism

作　　者：李娟[1] 刘保军[1] 赵峰[1] 何丽荣[1] 

机构地区：[1]宁夏医学院附属医院核医学科,银川750004

出　　处：《中华核医学杂志》2005年第2期105-107,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　评价核素肺通气 灌注(V Q)显像、螺旋CT肺动脉造影(HCTPA)及血浆D 二聚体在诊断肺动脉血栓中的作用。方法　临床疑为肺动脉栓塞(PE)患者4 2例,男2 6例,女16例,平均年龄( 4 9 18±16 5 6 )岁,均行核素肺V Q显像、HCTPA及血浆D 二聚体测定。其中32例患者在行肺灌注显像时,选择双足背静脉注射肺灌注显像剂,同时完成双下肢静脉显像。结果　4 2例患者中34例经临床诊断为PE ,肺V Q显像诊断PE的灵敏度、准确性和阳性预测值分别为94 12 %、90 4 8%和94 12 % ,HCTPA分别为85 2 9%、83 33%和93 5 5 % ,D 二聚体分别为5 2 94 %、5 7 14 %和90 0 0 %。32例行下肢深静脉显像的PE患者中2 0例有下肢静脉血栓。结论　肺V Q显像无创、安全、简便,诊断PE的灵敏度、准确性高。核素肺显像诊断亚肺段水平PE的能力明显高于HCTPA。Objective To assess the value of radionuclide pulmonary ventilation perfusion imaging, helical CT pulmonary angiography (HCTPA) and D dimer assay in the diagnosis of pulmonary embolism (PE). Methods Forty two patients with clinically suspected PE were studied, male∶ female=26∶16, mean age was (49.18±16.56) years. All the patients underwent radionuclide pulmonary ventilation perfusion imaging, HCTPA and D dimer assay. The lower extremity deep vein imaging was performed on 32 patients. Results Of the 42 patients, 34 patients were clinically diagnosed with PE. The sensitivity, accuracy and positive predictive rate of diagnosis of PE by pulmonary ventilation perfusion imaging was 94.12%, 90.48%, 94.12%. The sensitivity, accuracy and positive predictive rate of diagnosis of PE by HCTPA was 85.29%, 83.33%, 93.55%. The sensitivity, accuracy and positive predictive rate of diagnosis of PE by D dimer assay was 52.94%, 57.14%, 90.00%. Of the 32 patients with lower extremity deep vein imaging, 20 patients were found with deep vein thrombosis. Conclusions Radionuclide pulmonary ventilation perfusion imaging is one of the most valuable methods in the diagnosis of PE, and it is non injury, safe, simple to use. The capacity of radionuclide pulmonary imaging in diagnosis of subsegmental PE is higher than that of HCTPA.

关 键 词：肺动脉栓塞 肺通气/灌注显像 血浆D-二聚体 螺旋CT肺动脉造影 下肢深静脉显像 价值 肺灌注显像剂 下肢静脉血栓 显像诊断 核素肺通气 肺动脉血栓 阳性预测值 平均年龄 静脉注射 临床诊断 灵敏度 准确性 PE 患者 双下肢 

分 类 号：R563.5[医药卫生—呼吸系统] R743.33[医药卫生—内科学]