Late Pulmonary Scintigraphic Defects After Uneventful Recovery from Focal Pneumonia in Children: Comparison with Initial Radiograph

本研究，乃針對曾患有局部且無明顯合併症肺炎之兒童，採用肺臟灌注掃描(99mTc MAA)與肺臟噴霧換氣掃描(99mTc DTPA)來研究其恢復後期之異常。共收集15個病例，年齡為2歲至12歲，經半年至1年之恢復期，受檢時胸部X光均已正常。結果，10個病例有掃描異常，且其中9個掃描異常處與原先肺炎胸部X光之位置相符，又發現上述與原先肺炎位置相符之9個病例中，有6個病例屬於換氣─灌注對稱性缺損，2個病例屬於高換氣─灌注不對稱性缺損，及1個病例為灌注性缺損。本研究顯示：在局部性且無合併症之兒童肺炎，常可見後期之肺臟掃描異常，而且以對稱性缺損居多。其原因可能是肺炎造成換氣不足之肺臟傷害，或是原已存在之氣道阻塞，再加上缺氧導致血管收縮之繼發性灌注不足所致。

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並列摘要

Pulmonary radionuclide studies provide reliable information on regional lung perfusion and ventilation. In children of focal pneumonia with consolidation on the chest radiographs, we determined the association between the initial pneumonia sites and the late lung ventilation-perfusion (V -P) scan abnormalities six months to one year later. Totally fifteen children, 9 males and 6 females, aged 2 to 12 years, were enrolled. All cases had normal chest radiographs in follow up, and had unremarkable respiratory symptoms or signs. Both of99mTc MAA perfusion scintigraphy and 99mTc DTPA radioaerosol ventilation scintigraphy were performed in 12 cases while the other 3 cases had only perfusion studies. As results of these findings, there were 10 abnormal lung scans, including 9 cases at comparable areas (66%) and one at incomparable area with the initial pneumonia sites. Among those 9 comparable cases, we found 6 ventilation/perfusion (V/ Q) matched defects, 2 high V/Q mismatched defects and one decreased perfusion defect. We concluded that abnormal lung V-P scans were frequently after uncomplicated pneumonia in childhood, mostly being matched defects, which may be secondary to local bronchial obstruction and decreased perfusion. However, they seem not always to correlate with the initial pneumonia sites.

並列關鍵字

99mTc MAA perfusion scintigraphy ； 99mTc DTPA ventilation scintigraphy ； V/Q mismatched defect ； V/Q matched defect ； pediatric pneumonia

國際替代計量

Late Pulmonary Scintigraphic Defects After Uneventful Recovery from Focal Pneumonia in Children: Comparison with Initial Radiograph

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