320排螺旋CT肺动脉造影与核素肺通气灌注扫描评价肺动脉栓塞的对照研究  

Comparative study between 320 spiral CT pulmonary angiography and nuclide lung ventilation perfusion scan in the diagnosis of pulmonary embolism

作　　者：周璐[1,2] 范占明[1,2] 徐磊[1,2] 于薇[1,2] 刘家祎[1,2] 晏子旭[1,2] 姜红[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所影像科,北京100029

出　　处：《临床肺科杂志》2015年第1期1-4,共4页Journal of Clinical Pulmonary Medicine

基　　金：北京市自然科学基金面上项目(No 7132086)

摘　　要：目的探讨以核素肺通气灌注扫描为参照,评价320排螺旋CT肺动脉造影诊断肺动脉栓塞的临床价值。方法 23例可疑PE患者为研究对象,分别采用核素肺通气灌注扫描和320排螺旋CT肺动脉造影进行检测,并以核素肺通气灌注扫描为诊断标准,评估320排螺旋CT肺动脉造诊断肺动脉栓塞临床价值。结果 23例患者460个有效肺段中核素肺通气灌注扫描显示128个肺段出现V/Q失衡,320排螺旋CT肺动脉造影显示124个肺段动脉血管充盈缺损。以NLVPS为参考,320排螺旋CT肺动脉造影诊断肺动脉栓塞的敏感性为0.95(95%CI:0.89-0.98),特异性为0.96(95%CI:0.94-0.98),阳性似然比为26.33(95%CI:14.71-47.12),阴性似然比为0.06(95%CI:0.03-0.11),诊断优势比为475.06(95%CI:179.99-1253.91)和受试者工作特征曲线下面积为0.98。结论 320排螺旋CT肺动脉造影可作为肺动脉栓塞的无创快速诊断方法。Objective To investigate the value of 320 spiral CT pulmonary angiography in the diagnosis of pulmonary embolism by comparing nuclide lung ventilation perfusion scan （NLVPS）. Methods 23 subjects with suspected pulmonary embolism were included in this study, and all of the included case were underwent NLUPS and 320 spiral CT pulmonary angiography test. The diagnosis index were calculated by comparing to NLUPS. Results 23 subjects with 460 lung segment were evaluated in this study. There were 132 lung segments with V/Q imbalance and 129 pulmonary segments with lung artery filling defect. The diagnosis sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio and area under the ROC were 0. 95 （95% CI：0. 89 -0. 98）, 0. 96 （95% CI：0. 94 -0. 98）, 26. 33 （95% CI：I4. 71 -47. 12）, 0. 06 （95% CI：0. 03 -0. 11 ）, 475. 06 （95% CI： 179. 99 - 1253.91 ） and 0. 98 respectively by comparing to NLVPS. Conclusion 320 spiral CT pulmonary angiography is a non-invasive diagnosis method for PE.

关 键 词：肺动脉栓塞 螺旋CT 肺通气灌注扫面 

分 类 号：R563.5[医药卫生—呼吸系统]