到PE或不到PE:输血SPECT/CT可以避免过度诊断
Aamir Ali, Akilan Gopal, Yang Lu1
1From the Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center.
Clinical nuclear medicine
|September 12, 2024
概括
这项研究强调了一例转移性乳腺癌病例,该病例呈现出模仿肺栓塞 (PE) 的症状. 诊断成像,包括SPECT/CT,是不确定的,强调了在癌症患者中诊断PE的复杂性.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 肺部医学 肺部医学
背景情况:
- 转移性乳腺癌可能会出现重叠的肺栓塞 (PE) 症状,如呼吸障碍和缺氧.
- 升高的d-二聚物水平进一步使这些患者的诊断图片复杂化.
- 的对比性过敏需要替代的成像策略.
研究的目的:
- 评估 perfusion 平面成像和SPECT/CT在诊断转移性乳腺癌和对比物过敏的患者肺栓塞的实用性.
- 在恶性瘤和疑似PE的设置中调查输液缺陷的原因.
主要方法:
- 进行了输液平面成像和胸部的SPECT/CT.
- 计算机断层扫描肺血管造影 (CTPA) 经过对比剂过敏的前期治疗后进行.
主要成果:
- 平面成像揭示了可以暗示PE的胸腔基缺陷.
- perfusion SPECT/CT证实了 perfusion 缺陷,但被解释为 PE 的负值,将发现归因于转移性压缩.
- CTPA最终排除了肺栓塞的可能性.
结论:
- 在转移性疾病患者中,输液成像检测结果可能会误导.
- 当外部压缩存在时,SPECT/CT可能无法可靠地排除PE.
- CTPA仍然是PE诊断的黄金标准,即使在需要前期治疗的对比过敏患者中也是如此.
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