用^(99m)Tc-MAA肺灌注显像评价全腔静脉-肺动脉连接术后的肺血分布  

Pulmonary Blood Distribution Evaluated by ^(99m)Tc-MAA Pulmonary Imaging in Patient after Total Cavopulmonary Connection

作　　者：孙晓昕[1] 楚军民[2] 王琦[1] 田月琴[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院核医学科,北京市100037 [2]中国医学科学院北京协和医学院阜外心血管病医院心外科,北京市100037

出　　处：《中国分子心脏病学杂志》2015年第3期1305-1307,共3页Molecular Cardiology of China

摘　　要：目的探讨全腔静脉-肺动脉连接术(TCPC)术对肺血分布的确切影响。方法应用99m锝-大颗粒聚合人血清白蛋白(MAA)上下肢分别给药法进行肺灌注显像,对17例TCPC术后患者肺血流灌注情况进行定量和定性研究。结果 17例患者中右肺优势灌注的患者为13例(76.5%)。右肺优势灌注的患者,上肢给药时,右肺血流灌注百分比(88±9.4%)显著高于左肺(12±9.4%),p<0.001;下肢给药时,右肺(46±22.4%)与左肺(54±22.4%)血流灌注百分比的差异无统计学意义。结论采用TCPC手术方式大部分患者能获得右肺优势血流灌注。用99mTc-MAA肺灌注显像,能定量地分析上、下腔静脉血液及全部静脉血液在左右肺的分布,是一种无创、简便、安全的评估TCPC术后肺血分布的方法。Objective To study blood distribution in total cavopulmonary connection （TCPC）. Methods 17 survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in left and right lungs, the distribution of blood flow from superior vena cava （SVC）, inferior vena cava （IVC） and the whole pulmonary blood flow in both lungs were quantitatively and qualitatively analysed. Results In 13 of 17 patients （76.5%）, the right pulmonary was the advantage of blood flow perfusion. When upper limb administered, fight lung perfusion percentage （88±9.4%） was significantly higher than that of left lung （12±9.4%）, P 〈 0.001; When lower extremity administered, right lung （46±22.4%） and left lung （54±22.4%） predicted no significant differences in blood perfusion percentage. Conclusion Most of the patients after TCPC can obtain the advantage of right lung perfusion. ^99mTc-MAA pulmonary perfusion imaging can quantitatively analyze pulmonary blood distribution from superior vena cava blood and inferior vena cava blood respectively, which is a noninvasive, simple and safe method to evaluate pulmonary blood flow after TCPC.

关 键 词：全腔静脉肺动脉连接术 核素肺灌注显像 肺血分布 

分 类 号：R654.3[医药卫生—外科学]