Gates G F, Orme H W, Dore E K
JAMA. 1975 Aug 18;233(7):782-6. doi: 10.1001/jama.233.7.782.
Thirty-nine children with various cardiac abnormalities were examined with perfusion lung scintigraphy with technetium Tc 99m macroaggregated albumin. Nuclide accumulation within each lung, which is proportional to the division of pulmonary arterial flow, was determined. Twenty-six patients had hyperperfusion of one lung, with a particularly high incidence occurring with the tetraoloy of Fallot, pulmonary artery stenosis or atresia, and following surgical systemic-pulmonic anastomoses. Consistent detection of imbalance in pulmonary flow by inspection of chest x-ray films was possible when one lung received at least 2 1/2 times the blood flow of the opposite side; with angiography, flow imbalance could be recognized when flow in one lung exceeded flow in the other by only 1 1/2 times. The radionuclide quantitative method was a more sensitive means of detecting early cases of mismatched pulmonary blood flow than roentgenography, which was nonquantitative and required the presence of relatively gross perfusion abnormalities before visual perception was possible.
对39名患有各种心脏异常的儿童进行了锝Tc 99m大颗粒聚合白蛋白灌注肺闪烁扫描检查。测定了每个肺内的核素蓄积情况，其与肺动脉血流分配成正比。26例患者出现一侧肺血流灌注过多，法洛四联症、肺动脉狭窄或闭锁以及外科体肺分流术后该情况发生率尤其高。当一侧肺接受的血流至少是对侧的2.5倍时，通过胸部X光片检查有可能持续检测到肺血流不平衡；通过血管造影，当一侧肺的血流仅超过另一侧1.5倍时就能识别血流不平衡。放射性核素定量方法是检测肺血流不匹配早期病例的一种比X线照相更敏感的手段，X线照相是非定量的，并且在视觉上能够察觉之前需要存在相对明显的灌注异常。
