| PREFACEThe pulmonary embolism has been already a familiar disease, domestic and international misdiagnosis leak rate are very high,The death rate occupies the third of the cause of death, it is just inferior to the tumour and coronary heart disease. Fleetly but accurately examining pulmonary embolism directly relates to the pulmonary embolism s treatment result and prognostic evaluation. The technology of the CT/ECT fusion imaging is a new no hurted examination. This research by making comparison with the traditional V/ Q, the spiral CT , evaluate the clinical value of the CT/ ECT fusion imaging in diagnosing.MATHERIALS AND METHODSWe chose thirty - eight suspicious patients suffered pulmonary embolism,25 women,mean age 50. 6(43 -72) ,13 men, average age 52. 2(42 -69). we chose thirty -eight suspicious patients suffered pulmonary embolism,25 women, mean age 50. 6(43 -72) ,13 men, average age 52.2(42 -69). After 99mTc -DTPA(30 -- 35mci) generally was placed in the atomized container,patients uni-formitily breathed into their lung,in eight projections,the each body position' s count is 5 x 105,zoom 1.5, matrix 256 x 256. The next day, the 99 mTcs -MAA(20 -25 mci) was injected in vein ( instep vein or elbow vein) ,two minutes later,the lung perfusion imaging was performed in eigtht projections, the each body position' s count is 5 x 105,zoom 1.5, matrix 256 x 256. After the lung perfusion imaging was performed, the lung perfusion' s ECT scan woulddone , and then the CT scan was performed, and then transfer the data of CT and ECT to the processing computer and process by osem,then fuse imaging. The angiography of spiral CT was performed in 32 ses single breathing cycle, scan from the head to the end of Aorta's bow,5 nuns/ ses bed, When patient was dyspnea, scan in 10 mms/ s bed. According to the standard of the pulmonary angiography or the general clinical analysis without the pulmonary angiography, compare the sensitivity and specificity's difference of the V/ Q, spiral CT and CT/ECT in the diagnosis of the pulmonary embolism,X2 -test was made.RESULTSIn 38 doubtful pulmonary embolism patients,21 patients were diagnosed according to the the pulmonary angiography or the general clinical analysis, remaining 2 pneumonias,3 pleuritis,3 heart debilities,2 lung cancers,2 lung emphysemas, 1 big alveolus ,4 coronary heart disease. In V/Q imaging, there were more than two lung mismatching segments in 19 patients of 21 cases, and diagnosed pulmonary embolism, another 2 patients had no mismatching lung segments, the sensitivity is 90.48%. There were 7 patients whose he V/Q imaging was normal in 17 no - pulmonary embolism patients, the pulmonary embolisms might be excluded, 3 patients were misdiagnosed pulmonary embolisms, the rest could not be confirmed,the specificity is 41.18%. In the spiral CT,the embolisms were found in 17 patients of 21 pulmonary embolisms,4 patients had no embolisms found, the sensitivity is 66.67% ,in 17 no - pulmonary embolism patients,5 cases were pneumonias 3 cases were pleuritis 2 cases were heart debilities 2cases were lung emphysemas, they were diagnosed no - pulmonary embolisms, another four coronary heart diseases and one heart debilitie were not diagnosed, the specificity is 70. 59%. In the CT/ECT fusion imaging,there were many perfusion segmental defects in the 20 lung perfusion tomogrophies, while there were no pathological changes in CT,and diagnosed pulmonary embolisms,the sensitivity is 95.54% ; In 17 no - pulmonary embolism patients, the CT/ECT fusion imaging displayed 7 normal cases and 8 abnormal cases,such as lung tumom lung emphysemas big alveolus,the specificity is 94.12%.DISCUSSIONThe misdiagnosis rate reach to 70 ~ 80% , which influence the treatment and prognosis severitily, although the pulmonary embolisms'diagnosis must depend on the pulmonary angiography,but its universalisma and mishurting were not much better than the V/Q imaging and the spiral CT.The radionuclide distributing defects displayed in the radionuclide V/Q imaging was consistent with v...
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