肺V/Q SPECT显像在纤维素性纵隔炎中的应用  

Application of lung V/Q SPECT imaging in fibrosing mediastinitis

作　　者：尹立杰[1] 刘杰[1] 刘晓建[1] 续蕊 颜珏[1] 郑玉民[1] Yin Lijie;Liu Jie;Liu Xiaojian;Xu Rui;Yan Jue;Zheng Yumin(Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing 100029, China)

机构地区：[1]中日友好医院核医学科,北京100029

出　　处：《中华核医学与分子影像杂志》2019年第6期356-359,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨肺灌注(Q) SPECT显像及通气(V) SPECT显像在纤维素性纵隔炎(FM)中的价值。方法回顾性分析2015年1月至2018年7月间于中日友好医院就诊并行肺V/Q SPECT显像的14例FM患者(男6例、女8例,平均年龄74岁)资料,观察其显像表现,并根据肺灌注及通气受损范围占全肺容积的百分比(%)将肺受损程度分为轻度(<20%)、中度(20%~50%)和重度(>50%)。采用χ2检验分析不同肺叶血流灌注受损的发生率。结果肺Q SPECT显像示14例患者左肺上叶有和无受累者分别有14和0例,左肺下叶、右肺上叶、右肺中叶、右肺下叶受累者相应例数分别为11和3例、14和0例、13和1例、12和2例。不同肺叶血流灌注受损的发生率相当(χ^2=6.198,P=0.185);肺灌注受损范围为轻度者1例,中度7例,重度6例。肺V SPECT显像示不同肺叶通气功能受损的发生率相当(χ^2=1.587,P=0.811);肺通气受损范围为轻度者11例,中度2例,重度1例。肺Q SPECT显像与肺V SPECT显像检出的FM受损肺段及亚肺段分别有119和41处,差异有统计学意义(χ^2=28.42,P<0.05),前者显示的受损范围较多,但两者显示的受损表现均呈肺段或亚段型分布。结论FM患者肺V/Q SPECT显像显示的受损均呈节段性分布,且肺灌注受损多于肺通气受损。肺V/Q SPECT显像可用于评价FM患者的肺灌注及通气受损范围和程度。Objective To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM). Methods From January 2015 to July 2018, 14 FM patients (6 males, 8 females, average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied. The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (<20%), moderate (20%-50%) and severe (>50%) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (%).χ2 test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe. Results According to the results of Q SPECT imaging, all 14 patients had impaired blood perfusion in the superior lobe of left lung, and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung, superior lobe of right lung, middle lobe of right lung, inferior lobe of right lung were 11/3, 14/0, 13/1, 12/2, respectively. The incidence rates of impaired blood perfusion in different lobes were not significantly different (χ^2=6.198, P=0.185). The range of lung perfusion defect was mild in 1, moderate in 7 and severe in 6 patients. The incidence rates of impaired blood ventilation in different lobes were not significantly different (χ^2=1.587, P=0.811). The range of lung ventilation defeat was mild in 11, moderate in 2 and severe in 1 patients. The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41, respectively (χ^2=28.42, P<0.05). There was more defect in Q SPECT imaging, but both methods showed segmental or subsegmental distribution. Conclusions The defect of V/Q SPECT imaging in FM patients is segmental in distribution, and more is observed in Q SPECT imaging. Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.

关 键 词：纵隔炎 纤维化 放射性核素显像 99m锝聚集白蛋白 99m锝高锝酸钠 

分 类 号：R564.2[医药卫生—呼吸系统] R817.4[医药卫生—内科学]