SPECT/CT融合显像与心脏彩超三维成像诊断肺栓塞的实验研究

目的 通过家兔自体血栓回输的方法建立急性肺动脉血栓栓塞（肺栓塞）模型,比较单光子发射计算机断层成像术（SPECT）融合显像与心脏彩超三维成像对急性肺栓塞的诊断价值.方法 30只日系大白兔采用自体血栓回输方法建立急性肺栓塞模型,栓塞后4小时后分别行SPECT/CT融合显像与心脏彩超三维成像,并与病理解剖结果进行对比分析.肺组织病例学检查：分别于栓塞显像后处死实验动物,观察栓子的分布情况.统计学采用x2检验.结果 成功建立28只兔肺栓塞模型,栓塞后4小时,SPECT/CT融合显像诊断肺栓塞阳性率为92.9％ （26/28）,其中,显示肺段及支受累11例,亚段受累15例,以肺下叶外侧段及后基底段以下亚段分支受累较多.心脏彩超三维成像阳性率为67.9％（19/28）,两者比较差异有统计学意义（P＜0.05）.结论 SPECT/CT融合显像与心脏彩超三维成像诊断肺栓塞具有较好的一致性,SPECT/CT融合显像敏感性高于心脏彩超三维成像,二者互补可提高临床肺栓塞诊断的准确率.

Experimental study of echocardiography and SPECT/CT imaging pulmonary embolism in the rabbit

Objective This study made a model of pulmonary thromboembolism in the rabbits,to compari the diagnostic value of echocardiography and SPECT of tomography fusion in pulmonary embolism.Methods 30 rabbits were modeled pulmonary embolism.From ear marginal vein inject 99mTc-MAA imaging agent after embolism 4 h for echocardiography and SPECT of tomography fusion imaging.General observation：put to death animals,observation group performance of lung tissue and the distribution of thrombosis.To test for statistical significance,x2 test was perfomed.Results Successfully established 28rabbits model of pulmonary embolism（confirmed by pathology）.SPECT/CT of tomography imaging pulmonary embolism pulmonary defect in the positive rate was 92.9％ （26/28）.Among the 28 rabbits with SPECT results,the abnormal segments detected were 11,the abnormal subsegments detected were 15.Most abnormal subsegments detected were lingulare and basale posterius.Echocardiography imaging pulmonary embolism pulmonary defect in the positive rate was 67.9％ （19/28）.The difference between them had statistical signif-icance（x2 =5.54,P ＜ 0.05）.Conclusion Echocardiography and SPECT/CT imaging can diagnose pulmonary embolism.Echocardiography and SPECT/CT imaging had been coherent on diagnostic pulmonary embolism.SPECT/CT imaging diagnosis of PE is significantly better than echocardiography.