中国医疗设备Issue(9)：27-30,4.DOI:10.3969/j.issn.1674-1633.2015.09.007
肺通气/灌注SPECT-CT融合显像在急性肺栓塞诊断中的应用价值研究
Effectiveness of Application of Lung Ventilation/Perfusion SPECT-CT Fusion Imaging in Diagnosis of Acute Pulmonary Embolism
摘要
Abstract
Objective To investigate the effectiveness of pulmonary ventilation/perfusion SPECT (Single-Photon Emission Computed Tomography) combined with low-dose CT (V/P-SPECT-CT) imaging in diagnosis of APE (Acute Pulmonary Embolism). Methods Medical imaging data of 116 suspected APE patients who were scanned by pulmonary V/P-SPECT-CT from January 2012 to January 2015 were retrospectively collected. CTPA (Computed Tomography Pulmonary Angiography) was performed in all the patients two days before/after V/P-SPECT-CT scanning so as to analyze the effectiveness of application of V/P-SPECT-CT in diagnosis and exclusive diagnosis of pulmonary segment and sub-segment APE lesions. Results Among 75 identiifed APE cases (240 affected pulmonary segments and 62 affected pulmonary sub-segments), the diagnostic sensitivity, speciifcity, accuracy, false positive rate and false negative rate of V/P-SPECT-CT for APE were 96%, 92.7%, 94.8%, 7.3%and 4%, respectively. Its diagnostic speciifcity was higher than that of CTPA and pulmonary P-SPECT-CT. Its false positive rate was lower than that of pulmonary P-SPECT-CT. Altogether 94.7%of APE lesions (235 pulmonary segments and 51 pulmonary sub-segments) were displayed on V/P-SPECT-CT imaging, which was obviously higher than that of CTPA (68.2%, 194 segments and 12 subsegment). In non-APE cases, 26 patients with chronic pulmonary diseases [including 10 with COPD (Chronic Obstructive Pulmonary Diseases);3 with pulmonary space occupying;7 with pleural or encapsulated effusion;6 with pneumonia or pulmonary closure] were revealed on pulmonary V/P-SPECT-CT imaging. Conclusion In combination with functional and anatomical imaging information, pulmonary V/P-SPECT-CT fusion imaging proved its advantages of higher diagnostic speciifcity and lower false negative rate in diagnosis of APE and also could provide diagnosis for non-APE patients, which had great advantages in the application.关键词
急性肺栓塞/融合显像/SPECT-CT/排除诊断/特异性Key words
acute pulmonary embolism/fusion imaging/single-photon emission computed tomography/computed tomography/exclusive diagnosis/speciifcity分类
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杨瑞,邵国强,王丽,孟庆乐,王峰,王自正..肺通气/灌注SPECT-CT融合显像在急性肺栓塞诊断中的应用价值研究[J].中国医疗设备,2015,(9):27-30,4.基金项目
国家自然科学基金资助项目（30670588）；江苏省自然科学基金资助项目（BK20130082）。 （）
