SPECT/CT肺灌注显像评价肺动脉球囊扩张成形术治疗慢性血栓栓塞性肺动脉高压效果  

SPECT/CT pulmonary perfusion imaging in evaluating efficacy of pulmonary balloon dilatation for treatment of chronic thromboembolic pulmonary hypertension

作　　者：丁新华 王海军[1] 王道英[1] 王茸 么坤 DING Xinhua;WANG Haijun;WANG Daoying;WANG Rong;YAO Kun(Department of Nuclear Medicine,Gansu Provincial Hospital,Lanzhou 730030,China)

机构地区：[1]甘肃省人民医院核医学科,甘肃兰州730030

出　　处：《中国医学影像技术》2020年第7期1022-1026,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81460072);甘肃省自然科学基金(17JR5RA057)。

摘　　要：目的以SPECT/CT肺灌注显像评价肺动脉球囊扩张成形术(BPA)治疗慢性血栓栓塞性肺动脉高压(CTEPH)的疗效。方法对18例CTEPH患者分别于BPA前及其后1~3个月内行SPECT/CT肺灌注显像,以经导管肺动脉造影为标准,评价BPA前、后SPECT/CT探测肺段灌注缺损及灌注改善情况。结果SPECT/CT肺灌注显像在BPA前探测肺段灌注缺损的敏感度、特异度、准确率、阳性预测值(PPV)及阴性预测值(NPV)分别为90.42%(302/334)、99.05%(418/422)、95.24%(720/756)、98.69%(302/306)及92.89%(418/450);BPA后探测灌注改善的敏感度、特异度、准确率、PPV和NPV分别为77.78%(56/72)、80.00%(24/30)、78.43%(80/102)、90.32%(56/62)及60.00%(24/40)。结论SPECT/CT肺灌注显像用于评价BPA治疗CTEPH后肺段灌注及改善具有较好临床价值。Objective To explore the efficacy of SPECT/CT pulmonary perfusion imaging for evaluation on therapeutic effect of balloon dilatation(BPA)for chronic thromboembolic pulmonary hypertension(CTEPH).Methods A total of 18 patients with CTEPH underwent SPECT/CT pulmonary perfusion imaging before and 1-3 months after BPA.Perfusion defect and perfusion improvement were observed before and after BPA taken catheter pulmonary angiography as standards.Results The sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)of SPECT/CT pulmonary perfusion imaging in detecting pulmonary perfusion defect was 90.42%(302/334),99.05%(418/422),95.24%(720/756),98.69%(302/306),92.89%(418/450),respectively before BPA,while perfusion improvement after BPA was 77.78%(56/72),80.00%(24/30),78.43%(80/102),90.32%(56/62)and 60.00%(24/40),respectively.Conclusion SPECT/CT pulmonary perfusion imaging has good clinical value in evaluating pulmonary segment perfusion and improvement in patients with CTEPH after BPA.

关 键 词：肺栓塞 高血压 肺性 正电子发射断层显像 体层摄影术 X线计算机 血管成形术 球囊 

分 类 号：R543.2[医药卫生—心血管疾病] R817.4[医药卫生—内科学]