放射性核素肺显像课件.pptVIP

放射性核素肺显像在肺栓塞诊断中的应用;肺栓塞的无创性诊断技术;肺灌注/通气显像在肺栓塞诊断中的应用;肺灌注显像;肺通气显像;正常肺灌注显像;肺栓塞的典型影像学表现;肺灌注显像;肺灌注显像;膈肌麻痹;胸主动脉瘤;鉴别诊断：COPD;肺灌注显像;溶栓前;消融术前;PIOPED I 图像评价标准;PIOPED II图像评价标准;PISA-PED诊断标准;Near-normal perfusion scan in a patient with postischemic chronic left heart failure. (A) The pulmonary blood flow is distributed predominantly to upper and anterior regions; (B) CXR shows enlarged heart, dilated upper lobe vessels, and mild interstitial edema.;?Abnormal perfusion scan in a patient with COPD and moderate emphysema. (A) The scintigraphic outline of the lungs is ill-defined with non segmental bilateral perfusion defects predominantly in upper lung regions; (B) posteroanterior and lateral CXRs show clear signs of emphysema predominantly in upper lung lobes.;Acute pulmonary embolism in a patient with COPD. (A) wedge-shaped perfusion defects are seen in the right lung (arrows); (B) coronal and sagittal CTA images show multiple arterial filling defects.;?Lung cancer in a patient with no history of COPD. (A) a single nonsegmental perfusion defect is seen in the posterior regions of the right lung; (B) posteroanterior and lateral CXRs show a rounded sharply defined opacity in the costo-vertebral region of the right lung.;两种图像评价标准的比较;J Nucl Med 2021, 49: 1741;N Engl J Med 2006, 354: 22;核素肺显像与CTPA的比较;CTPA诊断亚肺段肺栓塞的价值;CTPA诊断亚肺段肺栓塞的价值;Emerg Med J 2006, 23: 123;辐射剂量;核素肺显像的新进展肺灌注/通气断层(SPECT)显像;临床应用背景;肺灌注/通气SPECT显像的优势;正常肺灌注/通气SPECT显像;COPD合并PE;J Nucl Med，2004，45：1501;;Q/V SPECT图像评价标准;Q/V SPECT融合技术;;;CTPA与V/Q断层显像辐射剂量的比较;V/Q断层显像与CTPA的选择;放射性核素肺显像在肺高压中的应用;常规肺灌注显像的主要特点;动态肺灌注显像;M/33 LET=11 Sec MPAP=12mmHg ;Receiver operating characteristic (ROC) analysis of LET for diagnosing pulmonary hypertension. The area under the curve (AUC) of LET for diagnosis of pulmonary hypertension was 0.886. At a cutoff value of LET at 22.7 s, the sensitivity and specificity for diagnosing pulmonary hypertension with DPPI were 94.7% and 78.0%, respectively.;M/54 LET=27 Sec MPAP=26mmHg;F/52 LET=42 Sec MPAP=46mmHg;M/62