Neumann S M, Freyschmidt J, Holland B R, Henschel M, Gahnem N R
Radiologisches Zentrum, Zentralkrankenhaus St.-Jürgen-Strasse, Bremen.
Med Klin (Munich). 1997 Nov 15;92(11):635-41. doi: 10.1007/BF03044818.
Evaluation of the validity of spiral-CT compared with ventilation/perfusion (v/p) scintigraphy, the standard diagnostic tool in patients with suspected pulmonary embolism.
Prospective study of 70 patients with symptoms of acute pulmonary embolism: examination with both methods within 4 hours.
In 46 patients pulmonary embolism could be unequivocally excluded by both methods. Patients with high-probability-Tc-scans predominantly had central emboli on CT. In cases with medium or low probability-Tc-scans thrombi were usually visible in segmental arteries. In one patient with a non-suspicious scintigram spiral-CT was able to detect emboli in multiple segmental arteries.
Spiral-CT is a fast, safe and almost always available method for detection of pulmonary embolism. In our hands it is superior to v/p-scintigraphy. It allows direct detection of a thrombus and has additional advantages in differential diagnosis (e. g. lung carcinoma, infectious infiltration). In patients with clinical suspicion of pulmonary embolism spiral-CT should be the primary diagnostic modality.
评估螺旋CT与通气/灌注（V/P）闪烁扫描术相比的有效性，V/P闪烁扫描术是疑似肺栓塞患者的标准诊断工具。
对70例有急性肺栓塞症状的患者进行前瞻性研究：在4小时内用两种方法进行检查。
46例患者通过两种方法均可明确排除肺栓塞。高概率Tc扫描的患者在CT上主要有中央型栓子。中概率或低概率Tc扫描的病例中，血栓通常可见于节段动脉。1例闪烁扫描无异常的患者，螺旋CT能够检测到多个节段动脉的栓子。
螺旋CT是一种快速、安全且几乎随时可用的检测肺栓塞的方法。在我们手中，它优于V/P闪烁扫描术。它能直接检测血栓，在鉴别诊断（如肺癌、感染性浸润）方面还有其他优势。对于临床怀疑肺栓塞的患者，螺旋CT应作为主要诊断方式。
