肺灌注联合CT肺动脉成像对肺动脉狭窄合并肺动脉高血压的诊断价值
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摘要
目的探讨肺灌注显像联合CT肺动脉成像对肺动脉狭窄伴有肺动脉高血压的诊断价值。方法收集6例经右心导管及肺动脉造影确诊的肺动脉狭窄伴有肺动脉高血压患者的99mTc-MAA肺灌注显像和CT肺动脉成像资料进行分析。结结果肺灌注显像联合CT肺动脉成像对肺动脉狭窄诊断结果与肺动脉造影结果具有很好的一致性。两种检查方法对肺动脉高血压诊断的准确率均达到83%,联合诊断的准确率可达到100%。结论肺灌注显像是对肺动脉狭窄合并肺动脉高血压很有效的检测工具,联合CT肺动脉成像可以使部分患者避免不必要的有创检查,具有重要的临床价值。
Objective To investigate into the value of pulmonary perfusion imaging combined with computed tomography and pulmonary angiography(CTPA) in diagnosis of pulmonary artery hypertension(PAH)in patients with pulmonary artery stenosis. Method Totally six patients diagnosed with PAH and pulmonary stenosis by right heart catheterization and pulmonary angiography, who underwent both99 mTc-MAA pulmonary perfusion imaging and CTPA examination, were analyzed. Results Pulmonary perfusion imaging combined with CTPA highly accorded with pulmonary angiography in detecting the pulmonary artery stenosis.The diagnostic accuracy in detecting the PAH of the two methods was 83%, and in a combined manner could reach 100%. Conclusion Pulmonary perfusion imaging could be used as a good testing tool for PAH with pulmonary artery stenosis and, combined with CTPA, can avoid unnecessary invasive test in some patients, thus having important clinical value.
Objective To investigate into the value of pulmonary perfusion imaging combined with computed tomography and pulmonary angiography(CTPA) in diagnosis of pulmonary artery hypertension(PAH)in patients with pulmonary artery stenosis. Method Totally six patients diagnosed with PAH and pulmonary stenosis by right heart catheterization and pulmonary angiography, who underwent both99 mTc-MAA pulmonary perfusion imaging and CTPA examination, were analyzed. Results Pulmonary perfusion imaging combined with CTPA highly accorded with pulmonary angiography in detecting the pulmonary artery stenosis.The diagnostic accuracy in detecting the PAH of the two methods was 83%, and in a combined manner could reach 100%. Conclusion Pulmonary perfusion imaging could be used as a good testing tool for PAH with pulmonary artery stenosis and, combined with CTPA, can avoid unnecessary invasive test in some patients, thus having important clinical value.
引文
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[2]徐希奇,荆志成.第六届世界肺高血压会议:聚焦肺高血压定义与诊断分类更新[J].协和医学杂志, 2018, 9(3):197—201
[3]李克伟,刘凯,段鹏飞,等.支架植入术治疗恶性肿瘤所致肺动脉狭窄2例[J].介入放射学杂志, 2016, 25(10):867—869
[4] Mccann C, Gopalan D, Sheares K, et al. Imaging in pulmonary hypertension, Part 2:large vessel diseases[J].Postgraduate Medical Journal, 2012, 88(1040):317—325
[5]刘辰.肺动脉高血压与肺栓塞的放射性核素显像研究[D].北京:北京协和医学院,中国医学科学院,清华大学医学部, 2010
[6] Xia H, Jiang Y, Cai Y, et al. Isolated pulmonary vasculitis[J]. Circulation, 2015, 132(20):235—238
[7] Casta?er E, Alguersuari A, Andreu M, et al. Imaging findings in pulmonary vasculitis[J]. Seminars in Ultrasound Ct&Mri, 2012, 33(6):567—579
[8] Toledano K, Guralnik L, Lorber A, et al. Pulmonary arteries involvement in Takayasu's arteritis:two cases and literature review[J]. Seminars in Arthritis&Rheumatism,2012, 41(3):461—470
[9]王墨扬,熊长明,倪新海,等.慢性纤维性纵隔炎致肺动脉高血压一例[J].中国循环杂志, 2009, 24(3):193
[10] Gopalan D, Mccann C, Sheares K, et al. Imaging in pulmonary hypertension, Part 3:small vessel diseases[J].Postgraduate Medical Journal, 2012, 88(1041):397—406