大动脉炎累及肺动脉肺通气/灌注显像一例

Takayasu's arteritis involving pulmonary artery pulmonary ventilation/perfusion:a case report

笔者报道了一例大动脉炎累及肺动脉肺通气/灌注显像的病例。从临床症状、体征、实验室检查、影像学检查等方面分析该病例特点。肺通气/灌注显像示右肺全肺、左肺上叶尖后段、左肺下叶背段、左肺外基底段的肺通气、肺灌注显像不匹配。仅从肺通气/灌注显像结果来看,易误诊为肺栓塞,但结合患者病史、检查结果及相关文献,综合分析考虑为大动脉炎累及肺动脉。通过文献复习加深了对大动脉炎的认识。对于大动脉炎累及肺动脉患者,肺动脉造影检查为有创性,而肺通气/灌注显像为无创性,且诊断准确率也较高,不失为一种较好的诊断及疗效评估的手段,提示临床医师尽早采取积极的对症治疗措施,改善患者预后。

A case report where a Takayasu’s arteritis involving pulmonary artery was detected on pulmonary ventilation/perfusion imaging was presented.The characteristics of this case on the basis of clinical symptoms,signs,laboratory examinations and imaging examinations were analyzed.On the pulmonary ventilation/perfusion images,the "mismatches" were observed in the whole right lung,and the upper,posterior lobes,and basal segment of the left lung.Only from the results of pulmonary ventilation/perfusion examination,it is easy to be misdiagnosed as pulmonary embolism.While it is considered as a result of the pulmonary artery involvement in the Takayasu's arteritis,once the patient’s history and other examination results were analyzed,as well as the peer review of related literatures.In this case report,SPECT proved a non-invasive diagnostic tool for Takayasu's arteritis patient involved pulmonary artery.It offered precise diagnosis and thereby appropriate treatment strategies are taken on those patients.