Grau M, Leisner B, Rohloff R, Fink U, Moser E, Matzen K A, Häusinger K
Nuklearmedizin. 1981 Aug;20(4):178-82.
Twenty children with severe scoliosis underwent spirometry, chest X-ray and 133Xe ventilation studies before surgical correction by the Harrington operation. By means of functional scintigraphy the relative distribution of the functional residual capacity (FRC) and the wash-out curves (3-min-retention without background correction, mean time constant, effectivity index after background correction) were analysed quantitatively. The chest X-ray and the single-breath-phase of the ventilation study remained mostly unchanged, whereas the shifting of the FRC distribution towards the lung of the concave side indicated in all cases a regional ventilation restriction of the convex side. In addition the analysis of the wash-out curves showed a regional impairment of the alveolar ventilation of the convex side which exceeded the shifting of FRC distribution. Even in the cases with normal spirometric values all scintigraphic parameters were slightly pathological, probably due to the decreased lung function caused by the scoliosis. The effectivity index taking into account the respiration frequency, the tidal volume, the FRC and the dead space, was found to be the most accurate and sensitive parameter for the evaluation of regional ventilation impairment.
20名重度脊柱侧弯患儿在接受哈灵顿手术进行手术矫正前,进行了肺活量测定、胸部X光检查和133Xe通气研究。通过功能闪烁扫描法定量分析了功能残气量(FRC)的相对分布以及洗脱曲线(未进行背景校正的3分钟保留率、平均时间常数、背景校正后的有效性指数)。胸部X光检查和通气研究的单次呼吸阶段大多保持不变,而FRC分布向凹侧肺转移在所有病例中均表明凸侧存在局部通气受限。此外,洗脱曲线分析显示凸侧肺泡通气存在局部损害,且超过了FRC分布的转移。即使在肺活量测定值正常的病例中,所有闪烁扫描参数也均有轻微异常,这可能是由于脊柱侧弯导致肺功能下降所致。考虑呼吸频率、潮气量、FRC和死腔的有效性指数被发现是评估局部通气损害最准确、最敏感的参数。