肺通气/灌注显像在肺动脉栓塞疾病诊断中的价值

Diagnostic value of pulmonary ventilation or perfusion imaging in pulmonary embolism

目的评价核素肺通气/灌注(V/Q)显像在肺动脉栓塞(PE)诊断中的价值。方法临床疑有PE患者147例,均行肺通气/灌注(V/Q)显像。结果 147例患者中有91例V/Q显像诊断PE,56例V/Q显像正常或匹配,排除PE。临床最终确诊PE 83例,4例大动脉炎,4例正常。56例V/Q显像正常或匹配者均排除PE。肺V/Q显像对诊断PE的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为100%(83/83)、87.5%(56/64)、94.6%(139/147)、91.2%(83/91)和100%(56/56)。结论 V/Q显像灵敏度及阴性预测值高,提示其检出疾病的能力强,漏诊率低,且可作为排除PE的首选方法。

Objective To assess the value of pulmonary ventilation-perfusion（V/Q） imaging in the diagnosis of pulmonary embolism（PE）. Methods 147 sufferers with ctinically suspected pulmonary embolism were given pulmonary ventilation-perfusion imaging. Results Among the 147 sufferers, 91 were diagnosed as PE in V/Q imaging.56 of them were excluded PE with normal or matching V/Q imaging.At last, 83 were definitely diagnosed as PE, 4 of them were conformed as Takayasu＇s arteritis, and 4 of them were normal.56 with normal or matching V/Q imaging were all excluded PE.The sensitivity, specificity, accuracy,positive predictive value, and negative predictive value of PE by ventilation-perfusion imaging were 100 % （83/83）, 87.5 % （56/64）, 94.6 % （139/147）, 91.2 % （83/91）and 100 % （56/56） respectively.Conclusion The high sensitivity and negative predictive value of V/Q imaging indicates that it has high ability of detecting PE and low rate of missed diagnosis. V/Q imaging is the first choice for excluding PE.