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目的通过对急性肺栓塞患者的核素肺灌注显像与电子束计算机断层摄影术(EBCT)的对比分析,初步探讨两者之间存在差异的原因和规律,以及肺动脉血管阻塞与血流灌注变化之间的对应关系。方法20例急性肺栓塞患者,24h内先后接受核素肺灌注显像和EBCT肺血管增强造影。逐个肺段对比EBCT所显示的肺动脉阻塞与肺灌注显像所显示的肺血流灌注的情况。结果多数(81.7%)肺动脉完全闭塞型病变对应相应肺段的灌注完全缺失,血流灌注分布与非完全闭塞型病变相比有显著性差异(P<0.01)。在非完全闭塞型病变中,多级肺动脉病变对应灌注完全缺失的比例较高(60.0%),多级肺动脉病变与单级肺动脉病变相比,血流灌注亦有明显的差异(P<0.05)。而不同类型的非完全闭塞型病变所对应的血流灌注没有明显差异(P>0.05)。结论不同形式的血管阻塞所造成的血流灌注变化的不同,是EBCT与肺灌注显像存在差别的主要原因之一,肺栓塞的血管阻塞和灌注受损是相互联系又有所不同的两个方面,肺灌注显像和EBCT结合应用能够使肺栓塞的诊断和疗效评价更加全面准确。
OBJECTIVE: To investigate the causes and patterns of pulmonary artery perfusion imaging and electron beam computed tomography (EBCT) in patients with acute pulmonary embolism The correspondence between. Methods Twenty patients with acute pulmonary embolism received intracranial pulmonary perfusion imaging and EBCT pulmonary angiography successively within 24 hours. Pulmonary segmental comparison of pulmonary blood flow perfusion demonstrated by EBCT and pulmonary perfusion imaging. Results The majority (81.7%) of pulmonary artery occlusive lesions corresponding to the corresponding segment of lung perfusion was completely missing, distribution of perfusion and non-occlusive lesions were significantly different (P <0.01). In noncomplete occlusive lesions, the ratio of multistage pulmonary lesions to total perfusion was high (60.0%). There was also a significant difference in perfusion between multislice pulmonary artery lesions and single pulmonary artery lesions (P <0.05) . There was no significant difference in perfusion between different types of occlusive lesions (P> 0.05). Conclusions The difference of blood perfusion caused by different forms of vascular occlusion is one of the main causes of the difference between EBCT and lung perfusion imaging. The vascular occlusion and perfusion damage of pulmonary embolism are two interrelated and different In terms of lung perfusion imaging and EBCT combined with the diagnosis and efficacy evaluation of pulmonary embolism can be more comprehensive and accurate.