肺灌注显像评价小儿先天性心脏病肺高压

EVALUATION OF PULMONARY HYPER- TEN-SION IN CHILDREN WITH CONGENITALHEART DISEASE BY PERFUSION LUNG SCINTIGRAPHY

报告应用￣（９９ｍ）ＴＣ标记的大颗粒聚合白蛋白肺灌注显像所得肺灌注转移率（ｒｔ／ｌｔ值）估价４６例小儿先天性心脏病肺高压（ＰＨ）结果。发现全组ｒｔ／ｌｔ值与肺动脉平均压等肺血流阻力指标均呈明显负相关；ＰＨ组（ｎ＝３２）ｒｔ／ｌｔ值明显低于无ＰＨ组（ｎ＝１６）（Ｐ＜０．０ｌ）；ｒｔ／ｌｔ值且能定量估计手术前后ＰＨ水平。本法判断ＰＨ，其灵敏度和特异性分别为９２．１％和８６．９％。结果表明该技术安全简便，精确可靠，为一有价值无创伤检测ＰＨ的诊断方法。

AbstractPulmonary hypertension (PH) in 48 children withcongenital heart disease were estimated by rt / lt (lungperfusion shift ratio) obtained from Tc-99mmacroaggregated albumin (MAA) perfusion lungscintigraphy. The rt / lt ratios significantly correlatedinversely with mean pulmonary arterial pressure(mPAP), pulmonary vascular resistance (PVR),pulmonary arterial systolic pressure (PASP) andpulmonary capillary wedge paressure (PSWP) in allpatients. The rt / lt ratios in PH group (n =32) weresignigicantly higher than those in non-PH group(n= 16). The levels of PH in pre- or postoperationwere also evaluated by this method. Using the tech-nique, the sensitivity and specificity of rt/lt fordiagnosis of PH were 92.1% and 86.9% respectively.The results indicate that this method is a secure.simple, accurate and reliable noninvasive approach tothe estimation of PH.