Walker I, Aukland P, Hirsh J, Coates G, Cockshott P, Taylor R, Hull R
Can Med Assoc J. 1981 Jan 15;124(2):153-8.
Ventilation and perfusion lung scans were performed preoperatively and postoperatively in 169 patients and classified blindly according to preset criteria. Perfusion lung scan abnormalities were present in 25 (15%) of the preoperative scans and 42 (25%) of the postoperative scans; 16 (38%) of the 42 abnormal postoperative scans were identical to the preoperative scans. Perfusion defects indicating a "high probability" of pulmonary embolism (lobar or segmental defects) were present in 5 preoperative scans and 10 postoperative scans; the 10 postoperative scans were classified as showing "definite" (5), "possible" (1) or "no" (4) pulmonary embolism on the basis of the preoperative scan and the ventilation scan; none of the 10 patients had clinical evidence of pulmonary embolism. Venous thrombosis was present in 12 patients, including 4 of the patients whose lung scans showed definite pulmonary embolism. Thus, postoperative perfusion lung scan defects are potentially misleading even when large.
对169例患者在术前和术后进行了通气与灌注肺扫描，并根据预设标准进行盲法分类。术前扫描中有25例（15%）存在灌注肺扫描异常，术后扫描中有42例（25%）存在异常；42例术后异常扫描中有16例（38%）与术前扫描相同。提示肺栓塞“高概率”的灌注缺损（肺叶或节段性缺损）在5例术前扫描和10例术后扫描中出现；根据术前扫描和通气扫描，10例术后扫描被分类为显示“肯定”（5例）、“可能”（1例）或“无”（4例）肺栓塞；这10例患者中均无肺栓塞的临床证据。12例患者存在静脉血栓形成，其中包括4例肺扫描显示肯定肺栓塞的患者。因此，即使术后灌注肺扫描缺损较大，也可能产生误导。
