同机CT平扫联合核素肺通气灌注显像诊断恶性肿瘤患者肺血栓栓塞症

Study of combined computed tomography and pulmonary ventilation/perfusion tomography scintigraphy in diagnosis of pulmonary thromboembolism in patients with malignant tumor

目的探讨同机CT平扫联合核素肺通气灌注断层显像(V/Q-SPECT)在诊断恶性肿瘤患者肺血栓栓塞症(PTE)方面的临床应用价值。方法 50例临床疑诊肺栓塞恶性肿瘤患者行V/Q-SPECT及同机CT平扫,评价同机CT平扫联合V/Q-SPECT对该类患者的诊断效能。结果 34例患者最终诊断为肺栓塞;同机CT平扫联合V/Q-SPECT显像诊断的灵敏度、特异度、准确性分别为94.1%、93.8%及94.0%,V/Q-SPECT显像诊断的灵敏度、特异度、准确性分别为94.1%、87.5%及92.0%;同机CT平扫联合V/Q-SPECT显像特异度及准确性明显高于V/Q-SPECT(P<0.05)。结论同机CT平扫联合V/Q-SPECT显像诊断PTE的特异性及准确性更高,在诊断肿瘤患者肺栓塞方面具有临床应用价值。

Objective To evaluate the clinical application value of combined computed tomography and pulmonary ventilation/perfusion tomography scintigraphy（V/Q-SPECT）in diagnosis of pulmonary thromboembolism（PTE）in patients with malignant tumor.Methods Fifty malignant tumor patients suspected with PTE were performed V/Q-SPECT and CT lung scan.The diagnostic efficiency between V/Q-SPECT combined with CT scan and V/Q-SPECT alone were compared.Results Thirty-four patients were finally diagnosed with PTE.The sensitivity,specificity and accuracy of V/Q-SPECT/CT were 94.1%,93.8% and 94.0%respectively.On the other hand,the sensitivity,specificity and accuracy of V/Q-SPECT were 94.1%,87.5% and 92.0% respectively.V/Q-SPECT/CT in diagnosis specificity and accuracy was superior to those of V/Q-SPECT alone（P〈0.05）.Conclusion V/Q-SPECT/CT scan can provide better specificity and accuracy,and it had clinical values in the diagnosis of malignant tumor patients suspected with PTE.