肺灌注显像和肺动脉造影对大动脉炎患者的肺动脉病变的诊断比较  

Comparison of pulmonary perfusion imaging with pulmonary angiography in diagnosis of pulmonary involvement in Takayasu′s arteritis

作　　者：杨敏福[1] 何作祥[1] 李世国[2] 蒋雄京[3] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院核医学科,北京100037 [2]中国医学科学院中国协和医科大学阜外心血管病医院放射科,北京100037 [3]中国医学科学院中国协和医科大学阜外心血管病医院高血压诊治中心,北京100037

出　　处：《中华心血管病杂志》2005年第12期1095-1098,共4页Chinese Journal of Cardiology

摘　　要：目的比较大颗粒聚合人血清白蛋白(99Tcm-MAA)肺灌注显像和肺动脉造影诊断大动脉炎患者的肺动脉病变的能力。方法对21例(女性19例,男性2例)经临床确诊的大动脉炎患者的99Tcm-MAA肺灌注显像和肺动脉造影结果进行回顾性分析。结果11例肺动脉造影证实有肺动脉受累的患者,肺灌注显像均不正常;在肺动脉造影正常的10例患者中,8例肺灌注显像正常,另外2例肺灌注显像提示有灌注受损。因此,从对大动脉炎患者的肺动脉受累的检出上看,肺灌注显像和肺动脉造影总的诊断符合率为90.5%(19/21,Kappa值=0.81,P<0.0001)。在对受累肺段的检出上(狭窄和闭塞性病变),肺灌注显像和肺动脉造影总的诊断符合率为87.5%(331/378,Kappa值=0.74,P<0.0001)。结论对于大动脉炎患者的肺动脉病变的诊断,99Tcm-MAA肺灌注显像和肺动脉造影有良好的诊断符合率。肺灌注显像可以作为大动脉炎患者的肺动脉病变的一种无创性筛选检查。Objective To compare the diagnostic value of 99^Tc^m-MAA pulmonary perfusion imaging with that of pulmonary angiography for pulmonary involvement in Takayasu＇s arteritis. Methods Twenty-one patients （19 women, 2 men）, with diagnosed Takayasu＇ s arteritis and underwent both 99^Tc^m-MAA pulmonary perfusion imaging and pulmonary angiography, were retrospectively analyzed. Results Out of the 21 patients, pulmonary angiography detected 11 patients with pulmonary artery involvement whereas 13 patients were revealed perfusion defects by pulmonary perfusion imaging. The agreement of diagnosis by pulmonary perfusion imaging with that by pulmonary angiography existed in 19 patients （90. 5%, Kappa = 0. 81, P 〈 0. 0001 ）. There were 331 pulmonary segments consistently diagnosed by pulmonary perfusion imaging and pulmonary angiography in 378 pulmonary segments （87.5%, Kappa =0.74, P 〈 0. 0001 ）. Conclusions Pulmonary perfusion imaging is highly accorded with pulmonary angiography in detecting the pulmonary involvement in Takayasu＇s arteritis. Therefore, pulmonary perfusion imaging could be used as a non-invasive screening test for the oulmonary artery involvement in Takayasu＇s arteritis.

关 键 词：TAKAYASU动脉炎 放射性核素血管显像术 血管造影术 肺动脉 肺灌注显像 肺动脉病变 肺动脉造影 大动脉炎 诊断比较 患者 

分 类 号：R543.3[医药卫生—心血管疾病]