Moyses B, Weitzenblum E, Gérard G, Methlin G
Nouv Presse Med. 1978 Jun 17;7(24):2141-4.
Regional isotopic exploration of ventilation and pulmonary perfusion is not yet widely applied in clinical practice, by virtue of the complexity of the equipment required, but also because of the complicated and lengthy analysis of the results. In this respect, connection of the scintillation camera to a computer represents a major advance which other authors have already emphasized. Our own experience in this area and our method of exploration are described. The results of regional exploration in a group of 43 cases of chronic obstructive lung disease (33 patients of the chronic bronchitis type, 10 patients with emphysema) are analysed and discussed. The results indicate the following : in chronic bronchitis, a very marked fall in ventilation of the bases with inversion of the normal vertical ventilation gradient, and a fall in the ventilation/perfusion ratio of the bases; in emphysema, a fall in ventilation, but also and above all in regional perfusion of all territories with preservation of normal or even increased regional ventilation/perfusion ratios. Regional exploration may also be of value in the detection of early stages of obstructive lung disease, and in pre-operative assessment in thoracic surgery.
由于所需设备复杂,且结果分析复杂冗长,通气与肺灌注的区域同位素探查在临床实践中尚未得到广泛应用。在这方面,将闪烁照相机与计算机连接是一项重大进展,其他作者已强调过这一点。本文描述了我们在该领域的经验及探查方法。分析并讨论了一组43例慢性阻塞性肺疾病(33例慢性支气管炎型患者,10例肺气肿患者)的区域探查结果。结果表明:在慢性支气管炎中,肺底部通气显著下降,正常垂直通气梯度倒置,肺底部通气/灌注比值下降;在肺气肿中,通气下降,但最重要的是所有区域的区域灌注下降,而区域通气/灌注比值保持正常甚至升高。区域探查在阻塞性肺疾病早期检测及胸外科手术术前评估中也可能具有价值。