Grossman Z D, Gagne G, Zens A, Thomas F D, Chamberlain C C, Singh A, Cohen W N, Heitzman E R
J Nucl Med. 1979 Dec;20(12):1251-6.
We have occluded segmental and subsegmental pulmonary arteries in the dog with Swan-Ganz balloon catheters or i.v. injection of autologous clot, and have studied the chest with transmission computed tomography (TCT), Tc-99m-MAA gamma imaging, and plain radiographs. The arterial occlusions were between 1 and 5 hr old at the time of imaging. Radiographs revealed no lesions. Tc-99m MAA scanns revealed ten of 11 lesions. When a TCT image was made before i.v. injection of Renografin-60, two of 11 lesions were identified; after Renografin the score was four out of ten. The appearance of lesions on TCT was highly variable. Tc-99m-MAA gamma imaging, therefore, is far more accurate than TCT in the identification of small experimentally produced acute pulmonary arterial occlusions in the dog, and our study fails to suggest a secure place for TCT in the diagnosis of small, acute human pulmonary emboli. The commonly-held assumption that postembolic lung is oligemic is questioned.
我们使用Swan - Ganz气囊导管或静脉注射自体血凝块使犬的节段性和亚节段性肺动脉闭塞，并采用透射计算机断层扫描（TCT）、Tc - 99m - MAAγ显像和胸部平片对胸部进行研究。成像时动脉闭塞时间为1至5小时。平片未显示病变。Tc - 99m MAA扫描显示11处病变中的10处。在静脉注射泛影葡胺 - 60之前进行TCT成像时，识别出11处病变中的2处；注射泛影葡胺后，10处病变中有4处被识别。TCT上病变的表现差异很大。因此，在识别犬实验性产生的小的急性肺动脉闭塞方面，Tc - 99m - MAAγ显像远比TCT准确，并且我们的研究未能表明TCT在诊断小的急性人类肺栓塞中有可靠作用。栓塞后肺血减少这一普遍观点受到质疑。
