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1、肺通氣/血流灌注顯像與螺旋CT肺動脈造影診斷肺栓塞的實驗研究羅焱，張青，胡云，蘇紅媛（400037重慶第三軍醫(yī)大學(xué)新橋醫(yī)院核醫(yī)學(xué)科）【摘要】目的評價肺通氣/血流灌注（V/Q）顯像與64層螺旋CT肺動脈造影（SCTPA）診斷肺栓塞的靈敏度和特異性。方法12只家兔分成4個實驗組，另設(shè)2只作為對照組。實驗組經(jīng)頸靜脈插管注入海綿栓子制備急性肺栓塞模型，建模后分組行V/Q顯像和SCTPA檢查，隨后處死實驗動物行病理解剖，查找并記錄肺動脈栓子位置及數(shù)目。對照組頸靜脈插管注入生理鹽水，于24h和第3天處死。結(jié)果實驗組家兔術(shù)中死亡1只，11只建模成功。家兔處死后共解剖動脈165支，發(fā)現(xiàn)栓子4
2、3個，栓塞肺動脈39支。V/Q顯像共檢出36處節(jié)段肺動脈栓塞，與病理解剖對照，假陽性7處、假陰性10處；SCTPA共診斷栓塞肺動脈32支，假陽性6支、假陰性13支。V/Q顯像、SCTPA診斷實驗家兔肺栓塞的靈敏度分別為74.4%、66.7%，特異性94.4%和95.2%，準(zhǔn)確性89.7%和88.5%。結(jié)論肺通氣/血流灌注顯像診斷肺栓塞的靈敏度和準(zhǔn)確性高于64層螺旋CT肺動脈造影，而特異性稍低，但無統(tǒng)計學(xué)差異?！娟P(guān)鍵詞】肺栓塞；肺通氣/血流灌注顯像；肺動脈造影【中圖法分類號】【文獻(xiàn)標(biāo)志碼】AExperimentalstudyonthevValueofpulmonaryperfu
3、sion/ventilationimagingand64-slicecomputedtomographicpulmonaryangiographyofforacutepulmonaryembolisminrabbitsLuoYan,ZhangQing,HuYun,SuHongyuan(DepartmentofNuclearMedicine.XiaoqiaoHospital,ThirdMilitaryMedicalUniversity,Chongqing,400037,China)【Abstract】ObjectiveToevaluatethesensibilitiesands
4、pecificitiesofdiagnosisofforacutepulmonaryembolismwithperfusion/ventilationimaging(V/Q)andor64-slicescomputertomographypulmonaryangiography(SCTPA).Methods12Fourteenexperimentalrabbitswererandomlydividedinto42groups,thatis,asexperimentalgroups(n=12),andanothertworabbitsbeenascontrolgroup(n=2
5、).Therabbitsofexperimentalgroupwerefurtherequallyrandomizedinto4subgroups,2-hourgroup,24-hourgroup,3-daygroupand7-daygroup.Theanimalmodelofacutepulmonaryembolismwerepreparedbyjugularvenacatheterusingspongesasemboli.Therabbitsofcontrolgroupreceivedaninjectionofnormalsalineviacatheter.Pulmona
6、ryperfusion/ventilationimagingandpulmonaryangiographywereperformedaftertheoperation,thentherabbitswerekilledatthedifferentstudcorrespondingytimepointsandthepulmonarytissuebeenpathologicalinspectedtosearchingandrecordingthenumbersandlocationofemboli.Thecontrolgrouprabbitswerewereinjectedphys
7、iologicalsalinesolutionviacatheterafteroperation,andkilledaint24hoursand3daysrespectivelyforpathologicalobservation.ResultsOne1rabbitofexperimentalgroupdiedduringtheoperation,andtheleft11of12rabbitsweremadeasacutepulmonaryembolismmodelsuccessfully.Totall
