放射性核素显像对闭塞性肺血管病肺动脉高压的诊断价值

The Diagnostic Value of Radionuclide Techniques in Obliterative Pulmonary Vascular Disease and Pulmonary Hypertension

根据肺动脉造影和肺灌注显像检查。65例闭塞性肺血管病中,33例诊断为肺栓塞症(大块),肺灌注显像呈肺段以上分布的血流灌注缺损;32例不能解释的肺动脉高压中,20例诊断为慢性哑型肺血栓栓塞症,肺灌注显像呈不均匀的斑片状稀疏缺损;12例诊断为真正的原发性肺动脉高压症,肺灌注显像为正常或普遍稀疏。65例中63例肺动脉平均压增高,升高程度与肺血流受损范围和程度相关。

Sixty—five patients with obliterative pulmonary, vascular disease and pulmonary hypertension were studied with radionuclide techniques, including ^(99m)Tc—MAA pulmonary perfusion scan, ^(99m)Tc—DTPA aerosol ventilation scan and radionuclide ventricuography, Of the 65 patiens, 33 were diagnosed as pulmonary emblem by contrast pulmonary arteriography; the pulmonary perfusion sean(PPS)showed pulmonary segmental defects, and the ventilation scan was normal. Among the 32 patients with unexplained pulmonary hypertension (UPH), 22 were diagnosed as chronic silent pulmonary thrombo—embolism; the PPS showed small sub—segmental defects in both lungs. In 12 patients with primary pulmonary hypertension, the PPS revealed no significant defects, and Ventilation was normal as well. There was a correlation between the number of segmental pulmonary defects and pulmonary artery pressure(P<0.01).