Rabinovitch M, Rosenthal A, Sade R M, Castaneda A R, Treves S, Nadas A S
Pediatr Res. 1977 Oct;11(10 Pt 2):1117-21. doi: 10.1203/00006450-197711100-00012.
Thirty-nine ventilation and perfusion lung studies with xenon 313 were perfomed in 29 patients with D-transposition of the great arteries (DTGA). Fifteen patients had simple DTGA and 14 more complex anatomic features. Inequalitiies of ventilation (V) were present in 23% (9/39) and perfusion (Q) in 44% (17/39) of studies. Six patients with simple DTGA showed abnormal distribution of perfusion, all with increased flow to the right lung. Among the 14 patients with complex DTGA, eight (57%) had abnormal distribution of perfusion. In patients with pulmonary artery band, increased flow was directed toward the left lung, and in those with an aorticopulmonary anastomosis, increased flow was to the side of the shunt. Radionuclide angiograms were performed in 17 patients with DTGA, both before and after surgical repair. In all, an abnormal circulatory pattern was noted. Complete superior vena cava obstruction present in four patients and residual left to right shunt (Qp/qs greater than 1.7/liter) in three was confirmed at cardiac catheterization. Ventilation perfusion studies with xenon-313 and technetium-99m radionuclide angiogram were effective noninvasive techniques in assessing pulmonary function and hemodynamics in patients with DTGA.
对29例大动脉转位（DTGA）患者进行了39次用氙313的通气与灌注肺研究。15例患者为单纯DTGA，14例有更复杂的解剖特征。研究中，23%（9/39）的通气（V）和44%（17/39）的灌注（Q）存在不均等。6例单纯DTGA患者显示灌注分布异常，均表现为右肺血流增加。在14例复杂DTGA患者中，8例（57%）有灌注分布异常。在肺动脉束带患者中，血流增加指向左肺，而在有主肺动脉吻合术的患者中，血流增加至分流侧。对17例DTGA患者在手术修复前后均进行了放射性核素血管造影。总体上，均观察到异常的循环模式。心导管检查证实4例患者存在完全性上腔静脉梗阻，3例患者存在残余左向右分流（Qp/qs大于1.7/升）。用氙313进行的通气灌注研究和锝99m放射性核素血管造影是评估DTGA患者肺功能和血流动力学的有效的非侵入性技术。
