^(99m)Tc-MAA显像、X线片、超声、CT和肺动脉造影诊断肺栓塞的比较研究

A Comparative Study of ^(99m)Tc-MAA Imaging with X-ray, Ultrasonography, CT and Pulmonary Angiography in the Diagnosis of Pulmonary Embolism.

目的对比研究99mTc-MAA显像、X线片、超声、CT和肺动脉造影(PA)对下肢创伤及手术后(LEPP)患者并发肺栓塞(PE)的诊断价值。方法16例LEPP临床疑为PE的患者同期行99mTc-MAA肺血流灌注显像(PPI)、下肢深静脉显像(RNVI)、X线胸片、胸部和下肢超声、胸部CT、PA检查。以PA为标准,计算PPI、X线片、超声、CT诊断PE的灵敏度。结果①16例患者中PA证实14例为PE,其中左侧PE3例,右侧PE7例,双侧PE4例,排除PE2例;②PPI发现14例PE受累肺段168个,平均每例受累11.8±4.6(3-17)肺段;③PPI、X线片、超声、CT诊断PE的灵敏度分别为100%(14/14)、28.6%(4/14)、35.7%(5/14)、85.7%(11/14);④RNVI发现71.4%(10/14)的PE有下肢深静脉血栓(DVT),超声提示78.6%(11/14)的PE有DVT(χ2=0.19,P>0.05)。结论99mTc-MAA显像为准确、无创、经济地诊断LEPP并发DVT和PE的影像学方法。

Objective To assess the diagnosis value of pulmonary embolism(PE) with ^(99m)Tc-MAA imaging,X-ray, ultrasonography,CT and pulmonary angiography(PA) in lower extremital posttraumatosis and postoperation(LEPP) patients. Methods 16 LEPP patients with clinical suspected PE underwent pulmonary perfusion imaging(PPI),radionuclide veins imaging(RNVI), X-ray, ultrasonography, CT and PA simultaneously.Results ①14 of 16 patients were confirmed to be with PE by PA. Both sides pulmonary artery embolism in 4 cases, left...