核素显像对疑肺栓塞患者诊断的对比性研究  

Clinical Evaluation of Nuclear Medicine Imaging in Diagnostic Approaches Pulmonary Embolism

作　　者：陈萍[1] 魏献忠[1] 梁伟坚[1] 朱卫国[1] 袁桂卿[1] 叶广春[1] 

机构地区：[1]广州医学院第一附属医院核医学科,广州510120

出　　处：《现代临床医学生物工程学杂志》2003年第3期211-212,220,共3页Journal of Modern Clinical Medical Bioengineering

摘　　要：目的　研究核素下肢静脉造影和肺灌注 /通气显像对肺栓塞 (PE)的诊断、治疗及预后的评价 .方法　 31例怀疑深静脉血栓形成 (DET)患者行核素下肢静脉造影、肺灌注 /肺通气显像 ;1例行核素上腔静脉造影 ;2例行核素下腔静脉造影 .与高速螺旋CT、彩超、X线胸片结果对比进行评价 .结果　核素下肢静脉造影阳性 2 0 /31例 .其中肺灌注 /通气显像不匹配高度可能者诊断为PE 4 /2 0例 .伴急性PE症状者 2 /4例 ,在 2 4小时内行溶栓治疗后 ,症状消失 ,肺灌注像恢复正常 . 2 /4例治疗后肺灌注显像持续未恢复患者 ,3年随访肺灌注显像持续缺损与通气不匹配 ,出现肺动脉高压、肺原性心脏病 . 3/2 0例在 1年随访中先后发生PE .2例肿瘤患者下腔静脉造影发现癌栓阻塞 .8例下肢静脉造影和肺灌注 /通气显像正常的低概率病人 ,追踪 4个月未发现PE .结论　肺灌注Objective To search of nuclein lower extremity phlebography & perfusion/ventilation imaging refer to the diagnostic, the treatment & the evaluation of prognosis. Methods 31 suspect patients of deep veins of lower limb thrombosis were performed nuclein venous thrombosis of lower extremity phlebography & perfusion/ventilation imaging; 1 of 3 cancer patients was performed nuclein superior venacavography & 2 of them were performed nuclein inferior venacavography. Comparing to the results of high-speed spirals CT, color Doppler, X-ray thoracic radiography. Results 20/31 patients nuclein venous thrombosis of lower extremity phlebography are masculine. Among 4/20 patients with high opportunity uncoupling perfusion/ventilation imaging was diagnosed as PE. 2/4 patients with acute pulmonary embolism were performed thrombolysis treatment within 24 hours, the symptom was extinct, the perfusion imaging was reversed normally. 2/4 patients with acute pulmonary embolism that perfusion imaging were not reversion after treating with acute pulmonary embolism and the perfusion imaging continuous defect with ventilation uncoupling during 3 years, was diagnosed pulmonary hypertension and cor pulmonale. 2 patients with cancer was detected cancer embolism after inferior venacavography. 8 patients with lesion in veins of lower extremity was not occur pulmonary embolism that the perfusion/ventilation imaging was normally and low probabilistic. Conclusions The perfusion/ventilation imaging is available for the diagnosis of PE and the predict, the observing effect of high-risk group.

关 键 词：核素显像 肺栓塞 诊断 对比性研究 

分 类 号：R817.4[医药卫生—影像医学与核医学]