Pulmonary Scintigraphic Patterns of Empyema following Pneumonia after Completely Clinical Recovery in Pediatrics

小兒肺炎合併肺膿瘍臨床痊癒後之肺閃爍造影圖像形態

陳毓雯(Yu-Wen Chen) ； 莊雅雯(Ya-Wen Chuang) ； 徐健欽(Chien-Chin Hsu) ； 戴任恭(Zen-Kong Dai) ； 吳俊仁(Jing-Ren Wu)

《核子醫學雜誌》 18卷3期 (2005/09) Pp. 127-133

https://doi.org/10.6332/ANMS.1803.001

摘要

背景：核子醫學肺灌流及呼吸閃爍造影，對兒科肺炎患者合併肺膿瘍於臨床治癒後，肺功能狀況評估之有效性。
方法：八年間收集十二名兒科肺炎患者合併肺膿瘍，於臨床治癒後，接受標凖核子醫學肺灌流及呼吸閃爍造影追蹤，以評估肺功能狀況。
結果：閃爍造影呈現呼吸／灌流一致或不一致之局部缺陷，在臨床症狀痊癒後，痊癒初期呈現與肺炎侵犯處一致之呼吸／灌流一致之局部缺陷，隨肺泡功能修復，而轉為呼吸／灌流不一致之局部缺陷，除非存在不可逆病理進行。
結論：我們認為核子醫學肺灌流及呼吸閃爍造影提供高靈敏方法來評估肺臟之病理生理功能，且具價值成為兒科肺炎患者合併肺膿瘍，於臨床治癒後的影像追蹤方法。

關鍵字

肺炎合併肺膿 ； 肺呼吸－灌流造影 ； 小兒科

並列摘要

Background: In this study, we enrolled pediatric cases with history of pneumonia, resulting in empyema and evaluated the pulmonary function based on the ventilation and perfusion scintigraphy after complete clinical recovery.
Methods: During 8 years period, twelve children (5 males and 7 females, aged 2- to 14-year-old with the medium of 6-year-old) presenting with unilateral empyema following pneumonia were enrolled. Standard procedures of (superscript 99m)Tc-DTPA aerosol ventilation and (superscript 99m)Tc-MAA perfusion scintigraphy were performed in follow-up.
Results: The scintigraphy revealed pathophysiological presentation of ventilation-perfusion (V/Q) matched or mismatched defects in the lung after critical disease process. V/Q matched defect, corresponding with prior pneumonia patch was a typical pattern at beginning after recovery. However, V/Q mismatched defect always resulted from the progressive repaired ventilation lesion via a period of time, except certain irreversible disease process.
Conclusion: We consider that the ventilation-perfusion (V-P) scan is a high sensitive method to evaluate the pathophysiology of pulmonary functional status and has a value to become a follow-up procedure after recovery from empyema following pneumonia in pediatrics.

並列關鍵字

empyema following pneumonia ； ventilation-perfusion V-P scan ； pediatrics