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首页> 外文期刊>Respiration: International Review of Thoracic Diseases >Diagnosis of pulmonary embolism: Conventional ventilation/perfusion SPECT is superior to the combination of perfusion SPECT and nonenhanced CT
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Diagnosis of pulmonary embolism: Conventional ventilation/perfusion SPECT is superior to the combination of perfusion SPECT and nonenhanced CT

机译：肺栓塞的诊断：常规通气/灌注SPECT优于灌注SPECT和非增强CT的结合

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Background: Ventilation/perfusion single-emission photon CT (V/P-SPECT) is widely used to detect pulmonary embolism (PE). Any pathological deficit on P-SPECT with a corresponding unremarkable V-SPECT is considered an embolism. This means that a deficit on P-SPECT with a corresponding deficit on the ventilation scan correlates with other lung pathologies such as pneumonia, bullous emphysema or tumor. In principle, it is possible to identify any of these lung pathologies on nonenhanced chest CT and so this technique has the potential to replace V-SPECT in the diagnosis of PE. Today, SPECT/CT hybrid imaging systems are increasingly applied in clinical routines.Objectives: We investigated whether embolism can be diagnosed using a combined P-SPECT/CT hybrid imaging approach without V-SPECT.Methods: Ninety-three patients with clinically suspected embolism were investigated with standard V/P-SPECT and a nonenhanced CT scan on a combined SPECT/CT system. A diagnosis of embolism was based on V/P-SPECT (gold standard). P-SPECT/CT datasets were blinded and analyzed without any knowledge of the V-SPECT data. The accuracy of P-SPECT/CT was compared to the gold standard.Results: Embolism was diagnosed in 24/93 patients using V/P-SPECT. In total, 57 lung lobes were affected. P-SPECT/CT significantly (p < 0.01) overdiagnosed embolism in nonaffected patients. In total, 36 cases with 88 affected lung lobes were shown. The sensitivity was 95.8%, the specificity 82.6%, the false-negative rate 4.2% and the false-positive rate 17.3%.Conclusions: Our results demonstrate that a nonenhanced CT scan in a novel hybrid imaging system cannot replace V-SPECT in the scintigraphy-based diagnosis of PE. V-SPECT increases specificity and reduces the number of false-positive results when compared to 'perfusion-only' SPECT/CT.
机译：背景：通气/灌注单发射光子CT（V / P-SPECT）被广泛用于检测肺栓塞（PE）。 P-SPECT上的任何病理缺陷以及相应的不明显的V-SPECT被认为是栓塞。这意味着P-SPECT的缺陷和通气扫描的相应缺陷与其他肺部疾病（如肺炎，大疱性肺气肿或肿瘤）相关。原则上，可以在未增强的胸部CT上识别出任何这些肺部病变，因此该技术有可能在诊断PE中取代V-SPECT。如今，SPECT / CT混合成像系统已越来越多地应用于临床程序中。目的：我们调查了是否可以使用不使用V-SPECT的P-SPECT / CT混合成像方法来诊断栓塞方法：九十三名临床怀疑栓塞的患者在组合的SPECT / CT系统上使用标准V / P-SPECT和非增强CT扫描进行了研究。栓塞的诊断基于V / P-SPECT（黄金标准）。对P-SPECT / CT数据集不了解V-SPECT数据并进行分析。将P-SPECT / CT的准确性与金标准进行比较。结果：使用V / P-SPECT对24/93例患者进行了栓塞诊断。总共有57个肺叶受到了影响。 P-SPECT / CT在未受影响的患者中显着（p <0.01）过度诊断了栓塞。总共显示了36例，有88个受影响的肺叶。敏感性为95.8％，特异度为82.6％，假阴性率为4.2％，假阳性率为17.3％。结论：我们的结果表明，新型混合成像系统中的非增强CT扫描不能替代V-SPECT。基于闪烁显像的PE诊断。与“仅灌注” SPECT / CT相比，V-SPECT可提高特异性并减少假阳性结果的数量。

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