放射性核素肺通气／肺血流灌注显像在心肺疾病中的应用

目的 评估放射性核素肺通气／肺灌注显像在心肺疾病中的应用价值。方法64例胸部疾病患者，男38例，女26例。第1天静脉注射^99mTc-MAA（8mCi）做肺血流灌注显像，第2天经口雾化吸入^99mTc-DTPA做肺通气显像，两次显像采集条件与体位相同。结果28例肺癌患者病变部位肺通气／肺血流均有下降，其中央型肺癌血流降低明显。4例慢性阻塞性肺气肿患者肺通气严重降低，与肺功能测定显示肺通气功能严重受损、呼吸道阻力增加相符合。5例肺大疱患者肺通气／肺血流呈散在下降，与X线肺大疱部位一致。6例急性肺栓塞和2例肺动脉发育不良者有显著的肺血流灌注缺损，肺通气则正常，两者图像呈典型的不匹配。7例先天性心脏病患者中5例肺通气／肺血流正常，2例通气正常、血流下降。2例多发性大动脉炎肺血流灌注明显下降、通气正常。余4例原发性肺动脉高压患者、3例胸痛者和3例心肌病患者的肺通气／肺血流均正常。结论放射性肺通气／肺血流灌注显像在心、肺疾病的显像各有不同的特殊表现，尤其对急性肺栓塞和慢性阻塞性肺气肿诊断特异性很高。为临床治疗提供有意义的参考价值。

Clinic value of radionuclide pulmonary ventilation/perfusion imaging in cardiopulmonary disease

Objective To assess the clinic value of ventilation/perfusion lung scan in cardiopulmonary disease. Methods ventilation/perfusion lung scan were performed in 64 patients with cardiopulmonary disease including 28 lung cancer,4 COPD,5 bunamiodyl,7 congenital heart disease,3 chest pain,6 acute pulmonary embolism,4 primary pulmonary hypertension, 3 cardiomyopathy,2 left pulmonary artery hypoplasia,2 polyarteritis. Results Both ventilation and perfusion function decreased in 28 lung cancer patients,especially in central type lung cancer patients. Ventilation function depressed significantly in 4 COPD, consistent with the results of lung function test. Ventilation and perfusion function depressed dispersedly at the lesion in 5 patients with bunamiodyl ventilation imaging and perfusion imaging were typically dismatched because of no blood perfusion and normal ventilation at the lesion in all patients with acute pulmonary embolism and left pulmonary artery hypoplasia. Blood perfusion decreased remarkly and ventilation function was normal in patient with polyarteritis. Conclusion Ventilation/perfusion lung scan is a sensitive and specific noninvasive technology for diagnosis of acute pulmonary embolism and pulmonary artery hypoplasia. Besides,ventilation/perfusion lung scan is valuable for the therapeutic guide and evaluation of cardiopulmonary disease.