SPECT/CT肺灌注显像与肺通气/灌注平面显像在肺栓塞诊断中的应用比较

目的分析单光子发射型计算机断层/低剂量平扫CT(SPECT/CT)肺灌注显像与肺通气/灌注(V/Q)平面显像在肺栓塞诊断中的应用。方法将2017年6月至2018年10月我院收治的120例疑似肺栓塞患者作为研究对象,所有患者均进行SPECT/CT肺灌注显像和V/Q平面显像检查,以临床最终诊断结果为准,评估SPECT/CT肺灌注显像和V/Q平面显像对肺栓塞的诊断效能。结果 120例患者中最终有100例诊断为肺栓塞,其中肺段病变247个,亚肺段病变285个。SPECT/CT肺灌注显像对肺栓塞诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为89.00%、90.00%、89.17%、97.80%、62.07%,均大于V/Q平面显像的81.00%、80.00%、80.83%、95.29%、45.71%。SPECT/CT肺灌注显像对肺栓塞肺段病变检出率87.04%与V/Q平面显像的82.19%无显著差异(P>0.05),对亚肺段病变检出率92.28%高于V/Q平面显像的85.96%(P<0.05)。结论 SPECT/CT肺灌注显像对肺栓塞的诊断效能优于V/Q平面显像,且可提高对亚肺段病变检出率。

Application Comparison Between SPECT/CT Lung Perfusion Imaging and Pulmonary Ventilation/Perfusion Planar Imaging in the Diagnosis of Pulmonary Embolism

Objective To analyze the application of single photon emission computed tomography/low-dose plain CT(SPECT/CT) pulmonary perfusion imaging and pulmonary ventilation/perfusion(V/Q) planar imaging in the diagnosis of pulmonary embolism. Methods 120 patients with suspected pulmonary embolism in our hospital from June 2017 to October 2018 were selected as the study objects, all patients was given SPECT/CT lung perfusion imaging and V/Q planar imaging. Taking the final clinical diagnosis result as the standard, the diagnostic efficacy of SPECT/CT lung perfusion imaging and V/Q planar imaging for pulmonary embolism was evaluated. Results Of the 120 patients, 100 were diagnosed with pulmonary embolism, including 247 lesions in the lung segment and 285 lesions in the sub-pulmonary segment. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SPECT/CT lung perfusion imaging for pulmonary embolism were 89.00%, 90.00%, 89.17%, 97.80%, and 62.07%, respectively, which were greater than V/Q plane imaging(81.00%, 80.00%, 80.83%, 95.29%, and 45.71%). There was no significant difference in the detection rate of segmental lesions in lung embolism between SPECT/CT lung perfusion imaging(87.04%) and the V/Q plane imaging(82.19%)(P>0.05), and the detection rate of sub-segment lesions by SPECT/CT lung perfusion imaging was 92.28%, higher than that by V/Q plane imaging(85.96%)(P<0.05). Conclusion SPECT/CT lung perfusion imaging is superior to V/Q planar imaging in the diagnosis of pulmonary embolism, and it can improve the detection rate of sub-segment lesions.