^(99m)Tc-MAA肺灌注显像预测肺癌患者肺切除术后残余肺功能

The clinical study on prediction of remnants pulmonary function after pneumonectomy on lung cancer patients using ^(99m)Tc-MAA pulmonary perfusion imaging

目的应用99mTc-MAA肺灌注显像预测肺癌患者肺切除术后残余肺功能,避免术后因肺功能不能代偿而导致手术失败。方法21例经病理证实的原发性肺癌患者,术前进行99mTc-MAA肺灌注显像,评估手术范围,术前根据公式计算术后1秒钟用力呼气容积的预测值PFEV1.0,并与手术后2、12个月FEV1.0实测值进行相关性分析。结果根据99mTc-MAA肺灌注显像结果计算所得PFEV1.0与术后2、12个月FEV1.0实测值均呈显著正相关,术前预测值为1.61±0.7L(n=21),术后2个月实测值为1.48±0.6L(n=21),术后12个月FEV1.0实测值为1.59±0.4L(n=19),未发生术后肺功能不能代偿病例。结论99mTc-MAA肺灌注显像预测肺癌患者肺切除术后残余肺功能方法可靠、准确性高,有较高的临床实用价值,对于肺功能处于临界状态的患者尤为必要。

Objective To estimate pulmonary of post - operation lung remants in lung cancer patients using ^99mTc - MAA pulmonary perfusion imaging method, therefore avoid pneumonectomy failure caused by insufficient pulmonary function after the surery. Methods The study was performed with ^99mTc - MAA pulmonary perfusion imaging on 21 lung cancer patients whom were all definitely diagnosed by pathology before pneumonectomy, and evaluate surgical area. Then analyzed related actual measured value by comparing the numbers using the predicted forced expiratory volume in one second values（ PFEV1.0 ） which was calculated through ^99mTc - MAA pulmonary perfusion imaging pulmonary perfusion imaging were compared with the measured values （ FEV1.0 ） at two months and twelve months after operation. Results The PFEV1.0 which calculated from the vesult of ^99m Tc - MAA pulmorary perfusion imaging were well correlated with FEV1.0 which measured at two months and twelve months after operation. The PFEV1.0 was 1.61 ± 0. 7L （n = 21 ）, FEV1.0 which measured at two months after operation was 1.48 ±0.6L（n = 21 ）, and FEV1.0 which measured at twelve months after operation was 1.59 ± 0.4L（ n = 19 ）. There were no case of insufficient pulmonary function after the surgery. Conclusion The results suggest that these methods are reliable and accurate, have high clinical importance and especially necessary for those patient have high risk with pulmonary function.