A comparison of ventilation perfusion combined with pulmonary perfusion fusion tomography ima-ging and CT pulmonary angiography for diagnosis of pulmonary embolism
10.3760/cma.j.issn.1008-1372.2019.07.014
- VernacularTitle:肺通气灌注联合肺灌注融合断层显像与CT肺动脉造影对肺栓塞诊断价值的比较
- Author:
Huixia GENG
1
;
Wanchun ZHANG
;
Caixia AN
;
Yahong LONG
;
Yuhua WANG
Author Information
1. 山西大医院核医学科
- Keywords:
Pulmonary embolism;
Tomography,emission-computed,single-photon;
Radionuclide imaging;
Angiography;
Tomography,jspiral computed
- From:
Journal of Chinese Physician
2019;21(7):1020-1023,1029
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the diagnostic value of ventilation/perfusion ( V/Q) combined with pulmonary perfusion single photon emission computed tomography combined with CT ( SPECT/CT) fu-sion tomography imaging and computed tomographic pulmonary angiography ( CTPA) in evaluation of pulmo-nary embolism. Methods We retrospectively analyzed 60 patients with clinically suspected pulmonary em-bolism diagnosed in Shanxi Dayi Hospital from May 2015 to May 2017. All patients underwent pulmonary V/Q imaging and lung perfusion SPECT/CT fusion tomography, and CTPA inspections were completed with-in 3 days. The final clinical diagnosis and follow-up confirmed the presence or absence of pulmonary embol-ism. The diagnostic efficacy of two imaging methods for pulmonary embolism were calculated and compared. Results Of the 60 cases of patients, 33 cases were diagnosed with pulmonary embolism; the sensitivity, specificity, and accuracy of V/Q combined with pulmonary perfusion SPECT/CT fusion tomography were 96. 97％ (32/33), 92. 59％ (25/27) and 95％ (57/60), respectively; the sensitivity, specificity, and accuracy of CTPA were 81. 82％ (27/33), 92. 59％ (25/27) and 86. 67％ (52/60), respectively; both have no diagnostic uncertainty, there was no significant difference in the qualitative diagnosis of pulmonary embolism between the two examination methods ( P >0. 05 ) . V/Q combined with pulmonary perfusion SPECT/CT fusion tomography found 253 lung segment and 50 unmatched sub-pulmonary segments, including 15 V/Q mismatch lung segment and 5 sub-segment caused by lung lesions which were confirmed by lung perfusion SPECT/CT fusion image ( 5 interlobular or pleural effusion, 4 local emphysema and pulmonary bulla, 3 interlobular hypertrophy, 8 pulmonary parenchymal inflammation); CTPA found 3 sub-segmental pulmonary filling defects, 6 cases of false-negative cases were multiple sub-pulmonary segment pulmonary embolism. Conclusions V/Q combined with pulmonary perfusion SPECT/CT fusion tomography is similar to CTPA in diagnosing pulmonary embolism, and both of them have better diagnostic efficacy; the former has advantages in the diagnosis of sub-pulmonary segment pulmonary embolism, and can exclude false-posi-tive diagnoses due to other lung lesions and provide additional diagnostic information for lung disease.
