螺旋CT血管成像与核素肺通气/灌注显像及二者联用在肺栓塞诊断中的对比研究

Clinical evaluation of spiral CT angiography and ventilation - perfusion scintigraphy and the combination of the both in the diagnosis of pulmonary embolism

目的比较螺旋CT血管成像(SCTA)和核素肺通气/灌注(V-P)显像及二者联用在肺栓塞(PE)诊断中的临床价值。方法分析我院2001-2004年住院67例临床疑有PE的患者,同时进行了SCTA检查和V-P显像,以最终临床诊断为标准,分别评价两种显像方式单独及联合使用对PE诊断的临床价值。结果SCTA对PE诊断的灵敏度、特异性分别为82.7%, 92.1%,V-P显像分别为86.6%,73.0%,联合应用两种检查法,则诊断的灵敏度、特异性分别可提高到93.3%和94.6%。结论总体上SCTA对PE诊断的准确性优于V-P显像,可做为临床首选检查法;联合应用两种显像是目前最为理想的PE诊断方法。

Objective To evaluate the clinical capability of spiral CT angiography (SCTA) and ventilation - perfusion (V - P) scintigraphy and the combination of the both in the diagnosis of pulmonary embolism (PE). Methods Sixty - seven patients with suspected PE in our hospital between 2001 and 2004 underwent SCTA and V - P scintigraphy, Sensitivity and specificity for diagnosing PE were calculated for SCTA scans and V - P scintigrams, comparing with the final clinical diagnosis. Results The sensitivity for detection of PE with SCTA and V - P scintigraphy was 82. 7% and 86.6% ,and the specificity was 92. 1 % and 73.0% . By combining SCTA and V - P scintigraphy, the sensitivity and specificity were improved to 93. 3% and 94.6%. Conclusion SCTA is more accurate in the diagnostic procedure of PE comparing with the V - P scintigraphy, and can be the first thoice. The combination of SCTA and V - P scintigraphy will be most accurate.