Butler S P, Alderson P O, Greenspan R L, Doctor D G, DeFillipi V J
Department of Radiology, Columbia University, New York, New York.
J Nucl Med. 1990 Jan;31(1):46-51.
Technetium-99m diethylenetriaminepentaacetic acid ([99mTc]DTPA) radioaerosol scans performed on 21 consecutive artificially ventilated patients were compared to 50 similar scans performed on patients breathing without mechanical assistance. All patients were referred for evaluation of suspected pulmonary embolism. The comparison revealed increased extrathoracic tracheal and mediastinal tracheal deposition but less central bronchial deposition in the artificially ventilated patients. Peripheral penetration in both groups of patients was excellent. Within the artificially ventilated group, peripheral penetration of activity seemed equally good in patients receiving positive-end expiratory pressure ventilation (n = 14) and those ventilated with normal pressures (n = 7). The frequency of regions in which aerosol activity (A) was present in the same zone as a perfusion (P) defect was the same in the controls and artificially ventilated patients (12% against 14%) but the frequency of the reverse type of mismatch (i.e., P greater than A) was significantly higher in the artificially ventilated group (42% against 14%, p less than 0.001). The results suggest that [99mTc]DTPA aerosol scans in artificially ventilated patients are associated with good peripheral penetration of activity and frequently yield valuable clinical information.
对21例连续接受人工通气的患者进行了锝-99m二乙三胺五乙酸（[99mTc]DTPA）放射性气溶胶扫描，并与50例未接受机械辅助通气的类似患者的扫描结果进行了比较。所有患者均因疑似肺栓塞而接受检查。比较结果显示，人工通气患者的胸外气管和纵隔气管沉积增加，但中央支气管沉积减少。两组患者的外周穿透情况均良好。在人工通气组中，接受呼气末正压通气（n = 14）的患者和接受常压通气（n = 7）的患者的活性外周穿透情况似乎同样良好。气溶胶活性（A）与灌注（P）缺损出现在同一区域的频率在对照组和人工通气患者中相同（分别为12%和14%），但反向不匹配类型（即P大于A）的频率在人工通气组中显著更高（分别为42%和14%，p < 0.001）。结果表明，人工通气患者的[99mTc]DTPA气溶胶扫描具有良好的活性外周穿透，并且经常能提供有价值的临床信息。
