放射性核素显像对下肢深静脉病变和肺栓塞的临床观察

Clinical observation of deep venous thrombosis and pulmonary embolism with radionuclide imaging

为研究下肢深静脉血栓形成与肺栓塞发病之间的关系，对１７１例临床诊断为下肢静脉病变者，使用９９ｍＴｃ大颗粒聚合白蛋白（ＭＡＡ）进行下肢深静脉和肺灌注显像。其中１０例行Ｘ线下肢静脉造影，１８例肺栓塞患者行ＤＳＡ检查，１５例行ＭＲＩ检查。结果：下肢深静脉及肺灌注显像可见１７１例下肢静脉病变患者中有９８例（５７３％）合并肺栓塞；９８例肺栓塞患者中股静脉以上梗阻为７９例，占８０６％。与ＤＳＡ、ＭＲＩ和Ｘ线下肢静脉造影检查的符合率分别为８８９％、８６７％和９００％。故核素下肢深静脉显像结合肺灌注显像是诊断下肢深静脉血栓和肺动脉栓塞的有效方法。

PURPOSE Deep venous thrombosis (DVT) and pulmonary embolism was evaluated with radionuclide imaging METHODS 171 patients suspected of DVT complicated with pulmonary embolus were analyzed with 99m Tc MAA (115 males and 56 females) The ages were 22～78 years Scintigraphic procedures were carried out in γ camera (Toshiba GCA 90B) with an all purpose, parallelhole collimator and the data were processed by computer RESULTS The results of 171 cases of DVT (DVT) were analyzed Of 171 cases, 98 (57 3%) were diagnosed as pulmonary embolism (PE) Among them, the obstruction above fermoral vein were found in 79 cases (80 6%) The coincidence rate with DSA, MRI and X ray phlegraphy of lower extremities were 88 9%, 86 7% and 90 0% CONCLUSIONS The results indicated that 99m Tc MAA radionuclide imaging was effective for noninvasive detection of DVT and pulmonary embolism