Departments of Nuclear Medicine, UZ Brussel, Laarbeeklaan, Brussels, Belgium.
Clin Nucl Med. 2012 Dec;37(12):1182-3. doi: 10.1097/RLU.0b013e318263909a.
A 61-year-old man with severe chronic obstructive pulmonary disease presented to our hospital with recurrence of a right-sided spontaneous secondary pneumothorax. Thoracoscopic abrasion of the parietal pleura was performed, but an important air leak persisted. Presumed to originate from a bulla in the right upper lobe, bullectomy and pleural decortication were performed, but leakage remained. Lobectomy was considered, and quantitative ventilation/perfusion SPECT was performed to predict the functional outcome.Fused high-resolution CT/Tc Technegas images localized leakage not only to a bleb in the right upper lobe but also to the subcutaneous emphysema in the thoracic wall. The air leak resolved after conservative treatment.
一位 61 岁的老年男性，患有严重的慢性阻塞性肺疾病，因右侧自发性复发性气胸到我院就诊。虽然进行了胸腔镜胸膜磨损术，但仍存在重要的空气泄漏。考虑到空气泄漏可能源自右上肺大疱，因此进行了肺大疱切除术和胸膜剥脱术，但泄漏仍然存在。考虑行肺叶切除术，并进行定量通气/灌注 SPECT 以预测功能结果。融合高分辨率 CT/Tc 锝气体图像不仅定位泄漏到右上肺大疱，还定位到胸壁皮下气肿。经过保守治疗，空气泄漏得到解决。
