Stein Paul D, Freeman Leonard M, Sostman H Dirk, Goodman Lawrence R, Woodard Pamela K, Naidich David P, Gottschalk Alexander, Bailey Dale L, Matta Fadi, Yaekoub Abdo Y, Hales Charles A, Hull Russell D, Leeper Kenneth V, Tapson Victor F, Weg John G
Department of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48341-5023, USA.
J Nucl Med. 2009 Dec;50(12):1999-2007. doi: 10.2967/jnumed.109.063958.
The purpose of this review was to evaluate the accuracy of SPECT in acute pulmonary embolism. Sparse data are available on the accuracy of SPECT based on an objective reference test. Several investigations were reported in which the reference standard for the diagnosis of pulmonary embolism was based in part on the results of SPECT or planar ventilation-perfusion (V/Q) imaging. The sensitivity of SPECT in all but one investigation was at least 90%, and specificity also was generally at least 90%. The sensitivity of SPECT in 4 of 5 investigations was higher than that of planar V/Q imaging. The specificity of SPECT was generally higher, equal, or only somewhat lower than that of planar V/Q imaging. Most investigators reported nondiagnostic SPECT V/Q scans in no more than 3% of cases. Methods of obtaining SPECT images, methods of obtaining planar V/Q images, and the criteria for interpretation varied. The general impression is that SPECT is more advantageous than planar V/Q imaging.
本综述的目的是评估单光子发射计算机断层扫描（SPECT）在急性肺栓塞诊断中的准确性。基于客观参考标准，关于SPECT准确性的可用数据较少。有几项研究报告称，肺栓塞诊断的参考标准部分基于SPECT或平面通气灌注（V/Q）显像的结果。除一项研究外，SPECT在所有研究中的敏感性至少为90%，特异性通常也至少为90%。在五项研究中的四项中，SPECT的敏感性高于平面V/Q显像。SPECT的特异性通常高于、等于或仅略低于平面V/Q显像。大多数研究者报告称，SPECT V/Q扫描在不超过3%的病例中为非诊断性结果。获取SPECT图像的方法、获取平面V/Q图像的方法以及解读标准各不相同。总体印象是，SPECT比平面V/Q显像更具优势。
