螺旋CT肺动脉造影与核素扫描诊断肺栓塞的对比实验研究

目的：比较HCT肺动脉造影检查与核素通气／灌注检查对实验性肺栓塞的诊断敏感性和特异性。方法：在DSA下复制肺栓塞的动物模型。分别进行螺旋CT肺动脉造影和ECT通气／灌注检查。以病理解剖发现作为肺栓塞诊断标准，比较二者诊断肺栓塞的敏感性和特异性。结果：病理解剖发现栓塞肺段动脉和亚段肺动脉36处；螺旋CT肺动脉造影检查发现栓塞肺动脉30支。诊断敏感性和特异性分别为75％和97．9％。并可以同时发现肺实质内的继发改变；ECT通气／灌注检查发现栓塞肺动脉所致通气／灌注不匹配区33处，诊断敏感性和特异性分别为96％和90．6％。结论：螺旋CT肺动脉造影检查诊断肺栓塞不仅具有较高敏感性和特异性，而且可以同时发现肺实质内的继发改变，可以作为诊断肺栓塞的首选检查方法之一。

Comparison of Helical CT Pulmonary Angiography with Ventilation-Perfusion Scintigraphy on the Sensitivity and Specificity for Diagnosing Pulmonary Embolism:An Experiment Study

Objective: To compare the accuracy of helical computer tomography pulmonary angiography(HCTPA) with ventilation-perfusion scintigraphy(ECT V-P) for diagnosing pulmonary embolism.Methods: Eight canine pulmonary arteries were embolied with gelatin sponges under DSA guidance. Then the dogs underwent helical CT pulmonary angiography and ventilation- perfusion scintigraphy examination respectively.With anatomic findings as standard,the sensitivities and specificities diagnosing the lung embolism by both methods were compared.Results: Thirty six segment and subsegment arteries emboli were found by anatomic dissection, 30 embolized arteries were found by HCTPA,the diagnosing sensitivity and specificity were 75% and 97.9%, respectively.The secondary affection of pulmonary parenchyma was also found.Thirty three dismatch regions were found by ECT V-P examination,the diagnosing sensitivity and specificity were 96% and 90.6%,respectively. Conclusion:Not only with relatively high diagnosing sensitivity and specificity ,but with the action of diagnosing the secondary affection of pulmonary parenchyma ,the HCTPA could be used as the first-line approach for diagnosing pulmonary embolism.