Ibáñez-Bravo S, Banzo I, Quirce R, Martínez-Rodríguez I, Jiménez-Bonilla J, Martínez-Amador N, Parra J A, González-Macías J, Carril J M
Nuclear Medicine Department, University Hospital "Marqués de Valdecilla", Cantabria University, Molecular Imaging Group IDIVAL, Santander, Spain.
Nuclear Medicine Department, University Hospital "Marqués de Valdecilla", Cantabria University, Molecular Imaging Group IDIVAL, Santander, Spain.
Rev Esp Med Nucl Imagen Mol. 2016 Jul-Aug;35(4):215-20. doi: 10.1016/j.remn.2015.12.008. Epub 2016 Jan 30.
The aim was to compare ventilation/perfusion SPECT lung scintigraphy (V/Q-SPECT) and computed tomography pulmonary angiography (CTPA) in patients with suspicion of pulmonary embolism (PE).
This prospectively designed study included 53 patients with intermediate or high clinical probability of PE. A V/Q-SPECT and CTPA was performed on all patients. The V/Q-SPECT was interpreted according to the European Association of Nuclear Medicine and Molecular Imaging (EANMMI) guidelines. CTPA was reported as positive, negative, or indeterminate.
CTPA was positive in 22 cases, negative in 28, and indeterminate in 3. V/Q-SPECT was positive in 27 cases, negative in 24, and non-diagnostic in 2. In the 22 with positive CTPA, V/Q-SPECT was positive in 18, negative in 3, and non-diagnostic in 1. In the 28 with negative CTPA, V/Q-SPECT was positive in 8, negative in 19, and non-diagnostic in 1. In the 3 with indeterminate CTPA, V/Q-SPECT was positive in 1 and negative in 2. In the 2 non-diagnostic cases V/Q-SPECT, CTPA was positive in 1 and negative in one. In the 10 high clinical probabilities, CTPA and V/Q-SPECT were positive in 7, negative in 2, and in 1, CTPA was positive and V/Q-SPECT negative. In the 38 intermediate probability group, CTPA and V/Q-SPECT were positive in 11, negative in 17, with CTPA negative and V/Q-SPECT positive in 8, and in 2 CTPA was positive and V/Q-SPECT negative. The results show that V/Q-SPECT detected PE in 5 patients more than CTPA.
Our results show a 77% concordance of both techniques. Overall V/Q-SPECT detected PE in 18% more patients than CTPA in the intermediate group. Both techniques have a complementary role when a diagnosis cannot be made with one of them.
目的是比较通气/灌注单光子发射计算机断层扫描肺闪烁显像（V/Q-SPECT）和计算机断层扫描肺动脉造影（CTPA）在疑似肺栓塞（PE）患者中的应用。
这项前瞻性设计的研究纳入了53例临床可能性为中度或高度的PE患者。所有患者均接受了V/Q-SPECT和CTPA检查。V/Q-SPECT根据欧洲核医学与分子影像协会（EANMMI）指南进行解读。CTPA报告为阳性、阴性或不确定。
CTPA阳性22例，阴性28例，不确定3例。V/Q-SPECT阳性27例，阴性24例，非诊断性2例。在CTPA阳性的22例中，V/Q-SPECT阳性18例，阴性3例，非诊断性1例。在CTPA阴性的28例中，V/Q-SPECT阳性8例，阴性19例，非诊断性1例。在CTPA不确定的3例中，V/Q-SPECT阳性1例，阴性2例。在V/Q-SPECT非诊断性的2例中，CTPA阳性1例，阴性1例。在临床可能性高的10例中，CTPA和V/Q-SPECT阳性7例，阴性2例，1例CTPA阳性而V/Q-SPECT阴性。在临床可能性为中度的38例中，CTPA和V/Q-SPECT阳性11例，阴性17例，CTPA阴性而V/Q-SPECT阳性8例，2例CTPA阳性而V/Q-SPECT阴性。结果显示，V/Q-SPECT比CTPA多检测出了5例PE患者。
我们的结果显示两种技术的一致性为77%。总体而言，在中度组中，V/Q-SPECT比CTPA多检测出18%的PE患者。当仅用其中一种技术无法做出诊断时，两种技术具有互补作用。
