^(99)Tc^m-MAA肺显像对深静脉血栓患者无症状肺栓塞的应用

Study of silent pulmonary embolism in patients with deep venous thrombosis using ^(99)Tc^m-MAA lung scan

目的 用99Tcm 大颗粒聚合白蛋白 (MAA)肺灌注显像研究肾病综合征伴下肢深静脉血栓患者的无症状肺栓塞发病情况。方法 75例肾病综合征伴下肢深静脉血栓而无任何肺部疾病临床症状的患者 ,均经临床和超声检查证实。所有患者同时进行99Tcm MAA下肢静脉和肺灌注显像 ,其中 45例并行99Tcm DTPA肺通气显像。结果 ① 75例患者中有 83% (62例 )发生下肢窝静脉以下血栓 ;②99Tcm MAA肺灌注显像示 61% (4 6例 )患者发生肺栓塞 (2 8例为单侧肺栓塞 ,18例为双侧肺栓塞 ) ;③ 45例患者99Tcm DTPA肺通气显像未见异常。结论 大部分肾病综合征下肢深静脉血栓患者伴有无症状性肺栓塞 ;

Objective Using 99 Tc m MAA lung scan,the incidence of silent pulmonary embolism (PE) was evaluated in patients with nephropathy syndrome complicated by deep venous thrombosis (DVT). Methods In 75 patients with DVT in nephropathy syndrome and without any signs of pulmonary disease proven by the clinical diagnosis and ultrasonography. 99 Tc m MAA scan of the lung and the deep vein was performed in all patients.Of these, 99 Tc m DTPA ventilation imaging was done in 45 patients. Results ①Low extremity DVT:in 75 patients,62(83%) were found with low extremity DVT in the subpopliteal vein. ②Pulmonary embolism: 99 Tc m MAA imaging showed that 46 patients were with PE, among them 28 with unilateral PE and 18 with bilateral PE.In patients with unilateral PE,22 were with right PE and 6 with left PE. About the PE locations,in right lung,23 were in lower lobe,12 in upper lobe and 5 in middle lobe; in left lung,11 in upper lobe and 13 in lower lobe. Conclusions 99 Tc m MAA lung scan demonstrated the high incidence of silent PE in patients with DVT in nephropathy syndrome. 99 Tc m MAA imaging should be used as a routine examination in order to find the PE in patients with DVT earlier.