增强磁共振肺灌注扫描与核素肺通气/灌注扫描诊断肺动脉栓塞

目的探讨增强磁共振肺灌注扫描技术(MRPP)与核素肺灌注扫描对照诊断肺动脉栓塞的临床应用价值.方法 19例肺动脉栓塞患者均行增强磁共振肺动脉造影(MRPA)、 MRPP及核素肺通气/灌注扫描.通过在上、中、下肺野和异常区域内设置感兴趣区,测量信号强度,绘制时间-信号曲线,获取灌注高峰期信号强度变化率.结果 19例诊断肺动脉栓塞的患者MRPP共发现186个肺灌注异常区, MRPP显示7例25个肺段合并段以远的肺动脉栓塞,核素显示188个段灌注缺损.MRPP中,正常灌注与灌注缺损区及低灌注区的信号强度变化率差异有显著性意义(P<0.01).结论与核素肺通气/灌注显像相比,MRPP同样能够显示肺栓塞的灌注缺损区和低灌注区.MRPP对段及段以远的肺动脉栓塞的显示有较高的临床价值.

Contrast enhanced MR pulmonary perfusion and radionuclide perfusion imaging in diagnosis of pulmonary embolism

Objective To investigate the value of MR pulmonary perfusion (MRPP) in diagnosing pulmonary embolism (PE) compared with pulmonary radionuclide perfusion imaging. Methods Total 19 patients with PE underwent MR pulmonary angiography, MRPP and pulmonary radionuclide perfusion imaging. Setting the ROI in top, middle, bottom of lung field and abnormal area respectively, we detected signal intensity and time-signal curve to obtain the transformation rate of signal (TROS) during perfusion peak value. Results In 19 patients, 186 abnormal pulmonary perfusion zones were found by MRPP, while 25 subsegments lesions were found in 7 cases, and 188 segments were showed by emission CT. The TROS in normal perfusion zones, perfusion defect zones, and low perfusion zones had significant difference (P<0.01). Conclusion Compared with the radionuclide perfusion, contrast enhanced MRPP could show both perfusion defect zones and low perfusion zones in PE. MRPP had significant values especially in showing pulmonary artery embolism in segments and subsegments.