Abstract：Objective To investigate the effectiveness of pulmonary ventilation/perfusion SPECT (Single-Photon Emission Computed Tomography) combined with low-dose CT (V/P-SPECT-CT) imaging in diagnosis of APE (Acute Pulmonary Embolism). Methods Medical imaging data of 116 suspected APE patients who were scanned by pulmonary V/P-SPECT-CT from January 2012 to January 2015 were retrospectively collected. CTPA (Computed Tomography Pulmonary Angiography) was performed in all the patients two days before/after V/P-SPECT-CT scanning so as to analyze the effectiveness of application of V/P-SPECT-CT in diagnosis and exclusive diagnosis of pulmonary segment and sub-segment APE lesions. Results Among 75 identified APE cases (240 affected pulmonary segments and 62 affected pulmonary sub-segments), the diagnostic sensitivity, specificity, accuracy, false positive rate and false negative rate of V/P-SPECT-CT for APE were 96%, 92.7%, 94.8%, 7.3% and 4%, respectively. Its diagnostic specificity was higher than that of CTPA and pulmonary P-SPECT-CT. Its false positive rate was lower than that of pulmonary P-SPECT-CT. Altogether 94.7% of APE lesions (235 pulmonary segments and 51 pulmonary sub-segments) were displayed on V/P-SPECT-CT imaging, which was obviously higher than that of CTPA (68.2%, 194 segments and 12 subsegment). In non-APE cases, 26 patients with chronic pulmonary diseases [including 10 with COPD (Chronic Obstructive Pulmonary Diseases); 3 with pulmonary space occupying; 7 with pleural or encapsulated effusion; 6 with pneumonia or pulmonary closure] were revealed on pulmonary V/P-SPECT-CT imaging. Conclusion In combination with functional and anatomical imaging information, pulmonary V/P-SPECT-CT fusion imaging proved its advantages of higher diagnostic specificity and lower false negative rate in diagnosis of APE and also could provide diagnosis for non-APE patients, which had great advantages in the application.
杨瑞，邵国强，王丽，孟庆乐，王峰，王自正. 肺通气/灌注SPECT-CT融合显像在急性肺栓塞诊断中的应用价值研究[J]. 中国医疗设备, 2015, 30(9): 27-30.
YANG Rui, SHAO Guo-qiang, WANG Li, MENG Qing-le, WANG Feng, WANG Zi-zheng. Effectiveness of Application of Lung Ventilation/Perfusion SPECT-CT Fusion Imaging in Diagnosis of Acute Pulmonary Embolism. China Medical Devices, 2015, 30(9): 27-30.
Bajc M,Neilly JB,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy:Part 1.Pulmonary imagingwith ventilation/perfusion single photon emission tomography[J].Eur J Nucl Med Mol Imaging,2009,36(8):1356-1370.
[3]
Konstantinides SV.2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism[J].Eur Heart J,2014,35(45):3145-3146.
[4]
Bajc M,Neilly J,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy[J].Eur J Nucl Med Mol Imaging,2009,36(9):1528-1538.
[6]
J?gi J,Palmer J,Jonson B,et al.Heart failure diagnostics based on ventilation/perfusion single photon emission computed tomography pattern and quantitative perfusion gradients[J].Nucl Med Commun,2008,29(8):666-673.
[1]
Bajc M,Neilly JB,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy:Part 1.Pulmonary imagingwith ventilation/perfusion single photon emission tomography[J].Eur J Nucl Med Mol Imaging,2009,36(8):1356-1370.
[2]
Howard LS,Hughes RJ.NICE guideline:management of venous thromboembolic diseases and role of thrombophilia testing[J].Thorax,2013,68(4):391-393.
[2]
Howard LS,Hughes RJ.NICE guideline:management of venous thromboembolic diseases and role of thrombophilia testing[J].Thorax,2013,68(4):391-393.
[2]
Howard LS,Hughes RJ.NICE guideline:management of venous thromboembolic diseases and role of thrombophilia testing[J].Thorax,2013,68(4):391-393.
[3]
Konstantinides SV.2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism[J].Eur Heart J,2014,35(45):3145-3146.
[4]
Bajc M,Neilly J,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy[J].Eur J Nucl Med Mol Imaging,2009,36(9):1528-1538.
[4]
Bajc M,Neilly J,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy[J].Eur J Nucl Med Mol Imaging,2009,36(9):1528-1538.
[7]
Roach PJ,Schembri GP,Bailey DL.V/Q scanning using SPECT and SPECT/CT[J].J Nucl Med,2013,54(9):1588-1596.
[7]
Roach PJ,Schembri GP,Bailey DL.V/Q scanning using SPECT and SPECT/CT[J].J Nucl Med,2013,54(9):1588-1596.
[1]
Bajc M,Neilly JB,Miniati M,et al.EANM guidelines for ventilation/perfusion scintigraphy:Part 1.Pulmonary imagingwith ventilation/perfusion single photon emission tomography[J].Eur J Nucl Med Mol Imaging,2009,36(8):1356-1370.
[3]
Konstantinides SV.2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism[J].Eur Heart J,2014,35(45):3145-3146.
[5]
J?gi J,Ekberg M,Jonson B,et al.Ventilation/perfusion SPECT in chronic obstructive pulmonary disease:an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT[J].Eur J Nucl Med Mol Imaging,2011, 38(7):1344-1352.
[6]
J?gi J,Palmer J,Jonson B,et al.Heart failure diagnostics based on ventilation/perfusion single photon emission computed tomography pattern and quantitative perfusion gradients[J].Nucl Med Commun,2008,29(8):666-673.
[5]
J?gi J,Ekberg M,Jonson B,et al.Ventilation/perfusion SPECT in chronic obstructive pulmonary disease:an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT[J].Eur J Nucl Med Mol Imaging,2011, 38(7):1344-1352.
[5]
J?gi J,Ekberg M,Jonson B,et al.Ventilation/perfusion SPECT in chronic obstructive pulmonary disease:an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT[J].Eur J Nucl Med Mol Imaging,2011, 38(7):1344-1352.
[6]
J?gi J,Palmer J,Jonson B,et al.Heart failure diagnostics based on ventilation/perfusion single photon emission computed tomography pattern and quantitative perfusion gradients[J].Nucl Med Commun,2008,29(8):666-673.
