Gutte Henrik, Mortensen Jann, Jensen Claus Verner, von der Recke Peter, Petersen Claus Leth, Kristoffersen Ulrik Sloth, Kjaer Andreas
Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Denmark.
Nucl Med Commun. 2010 Jan;31(1):82-6. doi: 10.1097/MNM.0b013e3283336747.
Planar ventilation/perfusion (V/Q) scintigraphy is currently the standard method for the diagnosis of pulmonary embolism (PE) in most nuclear medicine centers. However, recent studies have shown a superior sensitivity and specificity when applying V/Q single photon emission computed tomography (SPECT) in diagnosing PE. This study evaluated the diagnostic performance of three-dimensional V/Q SPECT in comparison with planar V/Q scintigraphy.
Consecutive patients suspected of acute PE from June 2006 to February 2008 were referred to the Department of Nuclear Medicine at Frederiksberg Hospital, Denmark to a V/Q SPECT, as the first-line imaging procedure. Patients with positive D-dimer (>0.5 mg/l) or after clinical assessment with a Wells score of more than 2 were included and had a V/Q SPECT, low-dose CT, planar V/Q scintigraphy, and pulmonary multidetector computer tomography angiography performed the same day. Ventilation studies were performed using Kr. Patient follow-up was at least 6 months.
A total of 36 patient studies were available for analysis, of which 11 (31%) had PE. V/Q SPECT had a sensitivity of 100% and a specificity of 87%. Planar V/Q scintigraphy had a sensitivity of 64% and a specificity of 72%.
We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.
平面通气/灌注（V/Q）闪烁扫描术目前是大多数核医学中心诊断肺栓塞（PE）的标准方法。然而，最近的研究表明，应用V/Q单光子发射计算机断层扫描（SPECT）诊断PE时具有更高的敏感性和特异性。本研究评估了三维V/Q SPECT与平面V/Q闪烁扫描术相比的诊断性能。
2006年6月至2008年2月期间，连续怀疑患有急性PE的患者被转诊至丹麦腓特烈斯贝医院核医学科，接受V/Q SPECT检查，作为一线成像检查。D-二聚体阳性（>0.5mg/l）或经临床评估Wells评分超过2分的患者被纳入研究，并于同日进行V/Q SPECT、低剂量CT、平面V/Q闪烁扫描术和肺部多排计算机断层扫描血管造影。通气研究使用氪进行。患者随访至少6个月。
共有36例患者的研究可供分析，其中11例（31%）患有PE。V/Q SPECT的敏感性为100%，特异性为87%。平面V/Q闪烁扫描术的敏感性为64%，特异性为72%。
我们得出结论，与平面V/Q闪烁扫描术相比，V/Q SPECT具有更好的诊断性能，在诊断PE时应优先选用。
