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目的 用99Tcm 大颗粒聚合白蛋白 (MAA)肺灌注显像研究肾病综合征伴下肢深静脉血栓患者的无症状肺栓塞发病情况。方法 75例肾病综合征伴下肢深静脉血栓而无任何肺部疾病临床症状的患者 ,均经临床和超声检查证实。所有患者同时进行99Tcm MAA下肢静脉和肺灌注显像 ,其中 45例并行99Tcm DTPA肺通气显像。结果 ① 75例患者中有 83% (62例 )发生下肢窝静脉以下血栓 ;②99Tcm MAA肺灌注显像示 61% (4 6例 )患者发生肺栓塞 (2 8例为单侧肺栓塞 ,18例为双侧肺栓塞 ) ;③ 45例患者99Tcm DTPA肺通气显像未见异常。结论 大部分肾病综合征下肢深静脉血栓患者伴有无症状性肺栓塞 ;对下肢深静脉血栓患者肺显像应作为常规检查
Objective To study the incidence of asymptomatic pulmonary embolism in patients with nephrotic syndrome and deep venous thrombosis of lower extremity using 99Tcm large particle polymeric albumin (MAA) lung perfusion imaging. Methods 75 patients with nephrotic syndrome with lower extremity deep vein thrombosis without any clinical symptoms of lung disease were confirmed by clinical and ultrasound. All patients underwent 99Tcm MAA venous and lung perfusion imaging at the same time, of which 45 were concurrent 99Tcm DTPA lung ventilation imaging. Results ① 83% of the 75 patients (62 cases) developed lower limb veins and thrombosis; ② 99Tcm MAA pulmonary perfusion imaging showed pulmonary embolism in 61% (46 cases) patients (28 cases of unilateral pulmonary embolism, 18 Cases of bilateral pulmonary embolism); ③ 45 cases of 99Tcm DTPA lung ventilation imaging no abnormalities. Conclusions Most patients with nephrotic syndrome have lower extremity DVT associated with asymptomatic pulmonary embolism. Lung imaging of DVT patients should be routinely performed