^(99m)Tc-MAA肺灌注SPECT/CT同机融合显像诊断肺栓塞的价值

Diagnosis value of pulmonary embolism by pulmonary perfusion SPECT/CT image fusion

目的探讨肺灌注SPECT/CT同机图像融合对无创诊断肺栓塞(PE)的应用价值。方法研究对象78例临床怀疑肺栓塞的患者,男26人,女52人,年龄28~80岁。78例患者均行99mTc-MAA肺灌注八方位静态显像、肺灌注SPECT/CT同机融合,通过OSEM迭代重建。结果本组78例患者临床最终确诊40例为肺栓塞患者,SPECT/CT同机图像融合诊断肺栓塞的灵敏度为90%(36/40),特异度为84.2%(32/38),假阳性15.8%(6/38),假阴性10%(4/40)。该法诊断PE的准确率为87.2%(68/78),与文献报道肺通气/灌注显像诊断PE的准确率近似(85%~92%)。结论肺灌注SPECT/CT同机图像融合显像能一次显像获得同一时间的肺灌注和透光度情况,在无创诊断肺栓塞中具有明显优势。

Objective： To investigate the value of diagnosis of pulmonary embolism by co-registration SPECT/CT image fusion.Methods：78 patients who were suspected pulmonary embolism were studied,man 26,female 52,28 to 80 years old.78 patients underwent 99mTc-MAA Lung perfusion image including eight-direction static imaging and SPECT/CT image fusion without changing the position of the patients.The emission image with X-ray map was reconstruct by OSEM.Results： Among 78 patients,40 were diagnosed pulmonary embolism by SPECT/CT.The sensitivity and specificity were 90%（36/40） and 84.2%（32/38）,fake masculine and fake negative were 15.8%（6/38） and 10%（4/40）.The exact rate of SPECT/CT image fusion was 87.2%（68/78）and was similar to that of pulmonary perfusion/ventilation imaging in literature reports.Conclusion： Pulmonary perfusion SPECT/CT image fusion can get both information of pulmonary perfusion and transparency in one study.The method had distinct advantages in diagnosing pulmonary embolism.