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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (6): 86-89.doi: 10.6040/j.issn.1671-7554.0.2014.872

• 临床医学 • 上一篇    下一篇

肺灌注SPECT/CT对不同Wells评分可疑肺栓塞的下肢深静脉血栓的诊断价值

吴大勇1, 张文艳1, 房保栓2, 邱刚2, 边艳珠1, 胡玉敬1   

  1. 1. 河北省人民医院 核医学科, 河北 石家庄 050051;
    2. 河北省人民医院 肿瘤科, 河北 石家庄 050051
  • 收稿日期:2014-11-26 修回日期:2015-02-28 发布日期:2015-06-10
  • 通讯作者: 边艳珠。 E-mail:hyx8144@126.com E-mail:hyx8144@126.com
  • 基金资助:
    河北省医学科学研究重点课题计划(20130414)

Diagnostic value of pulmonary perfusion SPECT/CT for lower-limb deep-vein thrombosis cases of patient with suspected pulmonary embolism which had different Wells scores

WU Dayong1, ZHANG Wenyan1, FANG Baoshuan2, QIU Gang2, BIAN Yanzhu1, HU Yujing1   

  1. 1. Department of Nuclear Medicine, People's Hospital of Hebei Province, Shijiazhuang 050051, Hebei, China;
    2. Department of Oncology, People's Hospital of Hebei Province, Shijiazhuang 050051, Hebei, China
  • Received:2014-11-26 Revised:2015-02-28 Published:2015-06-10

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摘要： 目的 探讨肺灌注SPECT/CT显像对不同Wells评分可疑肺栓塞的下肢深静脉血栓患者的诊断价值。方法 选取行肺灌注SPECT/CT显像可疑肺栓塞的下肢深静脉血栓患者210例,根据《2008版欧洲急性肺栓塞诊断治疗指南》推荐的Wells评分标准进行评分,总分≥7分为高度危险,≥2分、<7分为中度危险,<2分为低度危险。根据评分分为高度危险组(n=89)、中度危险组(n=64)及低度危险组(n=57)。对患者肺灌注SPECT/CT图像回顾性分析,计算3组肺栓塞的阳性率,利用SPSS 17.0对3组数据进行行乘列表χ2检验。结果 高度危险组阳性率为70.8%(63/89),中度危险组阳性率为29.7%(19/64),低度危险组阳性率为10.5%(6/57),3组阳性率差异有统计学意义(χ2=57.47, P<0.05)。结论 可疑肺栓塞下肢深静脉血栓患者Wells评分为高度或中度危险时,推荐行肺灌注SPECT/CT检查明确是否存在肺栓塞,以指导进一步的临床决策。当Wells评分为低度危险时,可暂不进行肺灌注SPECT/CT检查。

关键词: 深静脉血栓形成, 肺栓塞, SPECT/CT, 诊断, 肺灌注显像

Abstract: Objective To explore the diagnostic value of pulmonary perfusion SPECT/CT for patients with lower-limb deep-vein thrombosis (DVT) who may have pulmonary embolism (PE) with different Wells scores. Methods The study included DVT patients (n=210) with suspected PE. According to the Wells scores recommended by the 2008 European Pulmonary Embolism Diagnosis Guideline, the patients were divided into the high risk group (score ≥ 7, n=89), moderate risk group (2≤ score <7, n=64) and low risk group (score < 2, n=57). The patients' pulmonary perfusion SPECT/CT images were retrospectively analyzed. The positive rates of the three groups were calculated. The data were analyzed with chi-square(χ2)test. Results The positive rate of the high, moderate and low risk group was 70.8% (63/89), 29.7% (19/64) and 10.5% (6/57), respectively. There were statistical differences among the groups (χ2 = 57.47, P<0.05). Conclusion When DVT patients suspected of PE are diagnosed to have high risk or moderate risk by Wells scores, pulmonary perfusion SPECT/CT imaging should be recommended to confirm whether pulmonary embolism exists.

Key words: Pulmonary embolism, Pulmonary perfusion scintigraphy, Diagnosis, SPECT/CT, Deep venous thrombosis

中图分类号: 

  • R574
[1] 中华医学会心血管病学分会肺血管病学组. 急性肺血栓栓塞症诊断治疗中国专家共识[J]. 中华内科杂志, 2010, 49(1): 74-81.
[2] Kearon C. Natural history of venous thromboembolism[J]. Circulation, 2003, 107(23 Suppl 1): 22-30.
[3] Heit JA, Cohen AT, Anderson FA. Estimated annual number of incident and recurrent, non-fatsl and fatal venous thromboembolism (VTE) events in the US[J]. Blood, 2005, 106(2): 267.
[4] 吴大勇, 张文艳, 邱刚, 等. 肺灌注SPECT/CT显像对可疑肺栓塞患者的诊断价值[J]. 广东医学, 2014, 35(9): 1366-1368. WU Dayong, ZHANG Wenyan, QIU Gang, et al. The diagnostic value of pulmonary perfusion SPECT/CT in patients suspected pulmonary embolism[J]. Guangdong Medical Journal, 2014, 35(9): 1366-1368.
[5] Adam Torbicki, Chairperson, Arnaud Perrier, et al. Guidelines on the diagnosis and management of acute pulmonary embolism[J]. European Heart Journal, 2008, 29(18): 2276-2315.
[6] Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer[J]. Thromb Haemost, 2000, 83(3): 416-420.
[7] Delbeke D, Coleman RE, Guiberteau MJ, et al. Procedure Guideline for SPECT/CT Imaging 1.0[J]. J Nucl Med, 2006, 47(7): 1227-1234.
[8] Bajc M, Neilly JB, Miniati M, et al. EANM guidelines for ventilation/perfusion scintigraphy Part 2. Algorithms and clinical considerations for diagnosis of pulmonary emboli with V/P SPECT and MDCT[J]. Eur J Nucl Med Mol Imaging, 2009, 36(9): 1528-1538.
[9] Meneveau N, Seronde MF, Blonde MC, et al. Management of unsuccessful thrombolysis in acute massive pulmonary embolism[J]. Chest, 2006, 129(4): 1043-1050.
[10] 姚稚明, 王展. 肺通气灌注显像在肺栓塞临床处理过程中的应用价值[J]. 中华医学杂志, 2012, 92(26): 1813-1815.
[11] 王峰, 李全, 董薇, 等. 同机低剂量CT在肺通气/灌注SPECT显像诊断肺栓塞中的价值[J]. 中华核医学与分子影像杂志, 2011, 31(5): 320-323. WANG Feng, LI Quan, DONG Wei, et al. Additional diagnostic value of low dose CT in ventilation/perfusion hybrid SPECT for pulmonary embolism[J]. Chnia J Nucl Med, 2011, 31(5): 320-323.
[12] 吴大勇, 张文艳, 陈江红, 等. 肺灌注SPECT/CT评估肺栓塞治疗效果[J]. 中国医学影像技术, 2014, 30(4): 540-543. WU Dayong, ZHANG Wenyan, CHEN Jianghong, et al. Pulmonary perfusion SPECT/CT in evaluation on therapeutic effect of pulmonary embolism[J]. Chin J Med Imaging Technol, 2014, 30(4): 540-543.
[13] 张晶晶, 谢新立, 阮翘, 等. 99Tcm-MAA SPECT/CT融合显像与64排螺旋CT肺动脉成像诊断肺栓塞的对比研究[J]. 中华核医学与分子影像杂志, 2012, 32(2): 149-150.
[14] 吴大勇, 张文艳, 陈江红, 等. 肺灌注SPECT/CT显像对术后可疑肺栓塞患者的诊断价值[J]. 河北医药, 2014, 36(21): 3229-3231. WU Dayong, ZHANG Wenyan, CHEN Jianghong, et al. The diagnostic value of pulmonary perfusion SPECT/CT in post-operation patients suspected pulmonary embolism[J]. Hebei Medical Journal, 2014, 36(21): 3229-3231.
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