肺通气血流灌注显像与螺旋ct肺动脉造影诊断肺栓塞的实验研究

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1、肺通气/血流灌注显像与螺旋CT肺动脉造影诊断肺栓塞的实验研究罗焱，张青，胡云，苏红媛（400037重庆第三军医大学新桥医院核医学科）【摘要】目的评价肺通气/血流灌注（V/Q）显像与64层螺旋CT肺动脉造影（SCTPA）诊断肺栓塞的灵敏度和特异性。方法12只家兔分成4个实验组，另设2只作为对照组。实验组经颈静脉插管注入海绵栓子制备急性肺栓塞模型，建模后分组行V/Q显像和SCTPA检查，随后处死实验动物行病理解剖，查找并记录肺动脉栓子位置及数目。对照组颈静脉插管注入生理盐水，于24h和第3天处死。结果实验组家兔术中死亡1只，11只建模成功。家兔处死后共解剖动脉165支，发现栓子4

2、3个，栓塞肺动脉39支。V/Q显像共检出36处节段肺动脉栓塞，与病理解剖对照，假阳性7处、假阴性10处；SCTPA共诊断栓塞肺动脉32支，假阳性6支、假阴性13支。V/Q显像、SCTPA诊断实验家兔肺栓塞的灵敏度分别为74.4%、66.7%，特异性94.4%和95.2%，准确性89.7%和88.5%。结论肺通气/血流灌注显像诊断肺栓塞的灵敏度和准确性高于64层螺旋CT肺动脉造影，而特异性稍低，但无统计学差异。【关键词】肺栓塞；肺通气/血流灌注显像；肺动脉造影【中图法分类号】【文献标志码】AExperimentalstudyonthevValueofpulmonaryperfu

3、sion/ventilationimagingand64-slicecomputedtomographicpulmonaryangiographyofforacutepulmonaryembolisminrabbitsLuoYan,ZhangQing,HuYun,SuHongyuan(DepartmentofNuclearMedicine.XiaoqiaoHospital,ThirdMilitaryMedicalUniversity,Chongqing,400037,China)【Abstract】ObjectiveToevaluatethesensibilitiesands

4、pecificitiesofdiagnosisofforacutepulmonaryembolismwithperfusion/ventilationimaging(V/Q)andor64-slicescomputertomographypulmonaryangiography(SCTPA).Methods12Fourteenexperimentalrabbitswererandomlydividedinto42groups,thatis,asexperimentalgroups(n=12),andanothertworabbitsbeenascontrolgroup(n=2

5、).Therabbitsofexperimentalgroupwerefurtherequallyrandomizedinto4subgroups,2-hourgroup,24-hourgroup,3-daygroupand7-daygroup.Theanimalmodelofacutepulmonaryembolismwerepreparedbyjugularvenacatheterusingspongesasemboli.Therabbitsofcontrolgroupreceivedaninjectionofnormalsalineviacatheter.Pulmona

6、ryperfusion/ventilationimagingandpulmonaryangiographywereperformedaftertheoperation,thentherabbitswerekilledatthedifferentstudcorrespondingytimepointsandthepulmonarytissuebeenpathologicalinspectedtosearchingandrecordingthenumbersandlocationofemboli.Thecontrolgrouprabbitswerewereinjectedphys

7、iologicalsalinesolutionviacatheterafteroperation,andkilledaint24hoursand3daysrespectivelyforpathologicalobservation.ResultsOne1rabbitofexperimentalgroupdiedduringtheoperation,andtheleft11of12rabbitsweremadeasacutepulmonaryembolismmodelsuccessfully.Totall