Hosokawa N, Tanabe M, Satoh K, Takashima H, Ohkawa M, Maeda M, Tamai T, Kojima K
Department of Radiology, Kagawa Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1995 May;55(6):414-22.
In order to predict postoperative pulmonary function, 99mTc-MAA perfusion lung SPECT and spirometry were performed preoperatively in 52 patients with resectable primary lung cancer; 44 underwent lobectomy, eight pneumonectomy. Local pulmonary function (called local effective volume) was evaluated according to the degree of radionuclide distribution of each voxel in the SPECT images. The total effective volume was defined as the sum of the local effective volume, and the residual effective volume was the total effective volume excluding loss after operation. Predicted pulmonary function (VC and FEV1.0) was calculated by the following formula: Predicted value = preoperative value x percent of the residual effective volume. Postoperative pulmonary function was predicted in the same patients by means of 99mTc-MAA perfusion lung planar scintigraphy and X-ray CT. The patients were reinvestigated with spirometry at one and four months after surgery, and the values were compared with the predicted values. The correlations between the predicted values using SPECT and measured postoperative pulmonary function were highly significant (VC: r = 0.867, FEV1.0: r = 0.864 one month after operation; VC: r = 0.860, FEV1.0: r = 0.907 4 months after operation). The predicted values calculated using SPECT were accurate compared with the predicted values calculated using planar scintigraphy or X-ray CT. The patients with predicted FEV1.0 of less than 0.8 liter required home oxygen therapy. This method is valuable for the prediction of postoperative pulmonary function before the surgical procedure.
为预测术后肺功能，对52例可切除的原发性肺癌患者术前进行了99mTc-MAA肺灌注单光子发射计算机断层扫描（SPECT）和肺量计检查；44例行肺叶切除术，8例行全肺切除术。根据SPECT图像中每个体素的放射性核素分布程度评估局部肺功能（称为局部有效容积）。总有效容积定义为局部有效容积之和，残余有效容积为总有效容积减去术后损失部分。预测肺功能（肺活量（VC）和第1秒用力呼气容积（FEV1.0））通过以下公式计算：预测值=术前值×残余有效容积百分比。采用99mTc-MAA肺灌注平面闪烁扫描和X线计算机断层扫描（CT）对同一批患者进行术后肺功能预测。术后1个月和4个月对患者进行肺量计复查，并将结果与预测值进行比较。SPECT预测值与术后实测肺功能之间的相关性非常显著（术后1个月，VC：r = 0.867，FEV1.0：r = 0.864；术后4个月，VC：r = 0.860，FEV1.0：r = 0.907）。与平面闪烁扫描或X线CT计算的预测值相比，SPECT计算的预测值更为准确。预测FEV1.0小于0.8升的患者需要家庭氧疗。该方法对手术前预测术后肺功能具有重要价值。
