Value of pulmonary ventilation/perfusion single-photon emission computed tomography and CT imaging in the diagnosis of pulmonary embolism in elderly patients
10.3760/cma.j.issn.0254-9026.2022.07.016
- VernacularTitle:肺通气/灌注单光子发射计算机断层和低剂量CT融合显像在老年人肺栓塞中的诊断价值
- Author:
Congxia CHEN
1
;
Xu LI
;
Fugeng LIU
;
Xiaomao XU
;
Jianfei ZHANG
;
Zhiming YAO
Author Information
1. 北京医院核医学科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Pulmonary embolism;
Pulmonary ventilation;
Radioisotopes;
Tomography, emission-computed, single-photon
- From:
Chinese Journal of Geriatrics
2022;41(7):827-833
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the value of ventilation/perfusion single-photon emission computed tomography(SPECT)in combination with a low-dose CT scan(SPECT/CT)in diagnosing pulmonary embolism(PE)in elderly patients.Methods:In this retrospective study, data were collected from 279 patients with suspected PE and undergone SPECT/CT between January 2015 and December 2019 at Beijing Hospital, with 163 aged ≥65(the elderly group)and 116 aged <65(the control group). Based on diagnosis confirmed during follow-up as the final diagnosis, the diagnostic efficacy of ventilation/perfusion SPECT/CT in the two age groups was examined.The diagnostic efficacy of ventilation/perfusion SPECT/CT and age-adjusted D-dimer in the elderly group was also compared.The diagnostic efficacy of ventilation/perfusion SPECT/CT and CT pulmonary angiography(CTPA)was compared in 43 elderly patients who had undergone both ventilation/perfusion SPECT/CT and CTPA.Results:The sensitivity, specificity and accuracy of ventilation/perfusion SPECT/CT in the elderly group were 96.10%(74/77), 91.86%(79/86)and 93.87%(153/163)in the elderly group and 96.43%(27/28), 94.31%(83/88)and 94.83%(110/116)in the control group, respectively, with no statistically significant difference between the two groups( χ2=0.000, 0.409, 0.116, P=1.000, 0.522, 0.733). The sensitivity, specificity and accuracy of age-adjusted D-dimer were 84.42%(65/77), 63.95%(55/86)and 73.62%(120/163), and were significantly different from those of ventilation/perfusion SPECT/CT(all P<0.05). Among 43 elderly patients undergone ventilation/perfusion SPECT/CT and CTPA, 1 was excluded because the diagnosis based on CTPA was uncertain.The diagnostic sensitivity, specificity and accuracy of ventilation/perfusion SPECT/CT were 96.55%(28/29), 92.31%(12/13)and 95.24%(40/42)and those of CTPA were 65.52%(19/29), 92.31%(12/13)and 73.81%(31/42). They had the same specificity, but there were significant differences in sensitivity and accuracy( P=0.012, 0.022). Conclusions:Ventilation/perfusion SPECT/CT has higher accuracy in the diagnosis of PE in elderly patients, compared with CTPA and age-adjusted D-dimer.
