| 李晓玉,曹佳欣,张志琳,牛思宇,刘海燕.肺灌注SPECT/CT显像诊断肺栓塞并联合临床及实验室指标预测预后[J].中国医学影像技术,2025,41(4):606~610 |
| 肺灌注SPECT/CT显像诊断肺栓塞并联合临床及实验室指标预测预后 |
| Pulmonary perfusion SPECT/CT imaging for diagnosing pulmonaryembolism and combining with clinical and laboratory indicators for predicting prognosis |
| 投稿时间：2024-12-16 修订日期：2025-01-13 |
| DOI：10.13929/j.issn.1003-3289.2025.04.021 |
| 中文关键词: 肺栓塞 预后 血液学试验 单光子发射断层显像和计算机体层摄影 |
| 英文关键词:pulmonary embolism prognosis hematologic tests single photon emission computed tomography computed tomography |
| 基金项目:山西省高等教育"百亿工程"科技引导专项(BYYX004)。 |
| 作者 | 单位 | E-mail | | 李晓玉 | 山西医科大学第一医院核医学科, 山西 太原 030001
分子影像精准诊疗省部共建协同创新中心, 山西 太原 030001 | | | 曹佳欣 | 山西医科大学第一医院核医学科, 山西 太原 030001
分子影像精准诊疗省部共建协同创新中心, 山西 太原 030001 | | | 张志琳 | 山西医科大学第一医院核医学科, 山西 太原 030001
分子影像精准诊疗省部共建协同创新中心, 山西 太原 030001 | | | 牛思宇 | 山西医科大学第一医院核医学科, 山西 太原 030001
分子影像精准诊疗省部共建协同创新中心, 山西 太原 030001 | | | 刘海燕 | 山西医科大学第一医院核医学科, 山西 太原 030001
分子影像精准诊疗省部共建协同创新中心, 山西 太原 030001 | liuhaiyan-1203@126.com |
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| 中文摘要: |
| 目的 观察肺灌注SPECT/CT显像诊断肺栓塞(PE)并联合临床及实验室指标预测预后的价值。方法 回顾性收集260例疑诊PE,其中237例经临床确诊,对比肺灌注SPECT/CT显像与CT肺动脉造影(CTPA)的诊断效能。针对237例临床确诊PE中的160例首次发病并接受标准抗凝治疗及规律随访至出院后3个月者以logistic回归分析临床资料、实验室指标及基于肺灌注SPECT/CT显像的肺灌注缺损评分,筛选PE预后不良的独立预测因素并构建模型;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估模型对于PE预后的预测效能。结果 肺灌注SPECT/CT诊断PE的阳性率高于CTPA 。160例临床确诊PE中,51例预后不良、109例预后良好;年龄、血尿素氮、肌酐、尿酸、D-二聚体水平及肺灌注缺损评分均为PE预后不良的独立预测因素(P均＜0.05),以之构建的联合模型的AUC为0.731。结论 肺灌注SPECT/CT显像可用于诊断PE;联合临床及实验室指标能有效预测预后。 |
| 英文摘要: |
| Objective To explore the value of pulmonary perfusion SPECT/CT imaging for diagnosing pulmonary embolism (PE) and combining with clinical and laboratory indicators for predicting prognosis. Methods Totally 260 patients with suspected PE were retrospectively collected, and PE was clinically confirmed in 237 cases. The diagnostic efficacy of pulmonary perfusion SPECT/CT imaging and CT pulmonary angiography (CTPA) were compared. Among 237 patients with clinically confirmed PE, 160 cases were initially diagnosed who underwent standard anticoagulant therapy and were regularly followed up to 3 months after discharge, and their prognosis were analyzed. Logistic regression was used to analyze clinical data, laboratory indicators and pulmonary perfusion defect scores based on pulmonary perfusion SPECT/CT imaging to screen the independent predictors of poor prognosis of PE of the above patients, and a prediction model was then constructed. Receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of this model for predicting prognosis of PE. Results The positive rate of PE diagnosed with pulmonary perfusion SPECT/CT was higher than that with CTPA (66.54% vs. 59.62% , χ2=4.765, P=0.038). Among 160 cases of clinically confirmed PE, poor prognosis was observed in 51 cases, while good prognosis was noticed in 109 cases. Patients ’ age, blood urea nitrogen, serum creatinine, uric acid, D-dimer level and pulmonary perfusion defect score were all independent predictors for poor prognosis of PE (all P＜0.05), and AUC of the established combined model was 0.731. Conclusion Pulmonary perfusion SPECT/CT imaging could be used for diagnosing PE, and combining with clinical and laboratory indicators could effectively predict prognosis of PE. |
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