【摘要】 目的探讨⁹⁹Tc^m-MAA核素显像对腹膜透析患者胸腹瘘的诊断价值。方法对3例临床疑似胸腹瘘的持续性非卧床腹膜透析（CAPD）患者行⁹⁹Tc^m-MAA核素动态及延迟显像,监测腹腔渗漏情况,拟定辅助临床诊治方案。结果 1例患者延迟显像至24 h,未见明确腹腔渗漏征象,患者沿用原治疗方案,最终胸水量逐渐减少,至完全消失。1例患者右侧胸腔于9 min开始出现放射性分布,且随时间延迟逐渐增浓,诊断右侧胸腹瘘;1例患者右侧胸腔于1 h静态相时见弥漫性放射性分布,诊断为右侧胸腹瘘;临床因此调整了两者的透析方案,采用间断式腹膜透析,随后临床症状明显缓解,体征逐渐消失。结论 ⁹⁹Tc^m-MAA核素显像作为一种简便、无创、灵敏度高的检查方法,能对CAPD患者胸腹瘘准确定性、定位诊断,并为其后期治疗方案的调整提供可靠依据。更多还原

【Abstract】 Objective To investigate the clinical value of Technetium-99 m labeled macroaggregated albumin(⁹⁹Tc^m-MAA) scintigraphy used for the diagnosis of pleuroperitoneal communication（PPC） in patients undergoing continuous ambulatory peritoneal dialysis（CAPD）.Methods Two clinic-radiological suspected PPC patients during CAPD underwent dynamic and delayed imaging with ⁹⁹Tc^m-MAA, for identifying PPC to aid the treatment planning design.Results One case with negative ⁹⁹Tc^m-MAA imaging results was followed with the original treatment plan, and by the end of the plan, her pleural effusion disappeared completely.The other case showed the passage of radioactive material to the right chest at 9 min after administration of ⁹⁹Tc^m-MAA, which gradually increased overtime, thereby demonstrating the presence of PPC at this level. And then an intermittent peritoneal dialysis（IPD）was used to replace CAPD in this patient. Eventually, her clinical symptoms and sighs disappeared.Conclusion ⁹⁹Tc^m-MAAscintigraphy is a simple, non-invasive and high sensitivity method for the qualitative and positioning diagnosis of PPD in CAPD patients. Furthermore, it can also provide a reliable reference for the adjustment of late-stage treatment plan.更多还原