摘要目的：探讨传统的肺通气/灌注（V/Q）平面显像、肺灌注断层显像与低剂量平扫CT相结合（肺Q SPECT/CT）对肺栓塞的诊断价值。方法收集69例临床可疑肺栓塞患者，在对其行肺V/Q平面显像的同时，进行了肺Q SPECT/CT显像。以临床最终确诊结果为金标准，对两种方法的诊断结果进行对比分析。结果69例临床可疑肺栓塞患者，最终确诊43例，排除26例。肺Q SPECT/CT对肺栓塞诊断的灵敏度、准确率、阴性预测值及与临床最终确诊结果的Kappa值均较肺V/Q平面显像高；肺Q SPECT/CT对合并有慢性阻塞性肺疾病（COPD）的病例诊断的特异度较肺V/Q平面显像低。排除COPD病例的影响后，肺Q SPECT/CT的特异度明显提高，且高于肺V/Q平面显像的特异度。两种方法检出肺栓塞的一致性为85%（34/40），且两种方法检出率之间的差异有统计学意义（χ2=8.10，P<0.05）。结论肺Q SPECT/CT明显提高了对不伴有COPD的肺栓塞患者的诊断价值，用肺Q SPECT/CT取代肺V/Q平面显像值得商榷。

abstractsObjective To study the value of traditional pulmonary ventilation-perfusion (V/Q) planar imaging and pulmonary perfusion SPECT combining with low-dose CT ( Q SPECT/CT ) in the diagnosis of pulmonary embolism. Methods Sixty nine patients with suspected pulmonary embolism were collected. Pulmonary V/Q planar imaging was performed in all the patients, meanwhile, pulmonary Q SPECT/CT was taken. Taking the final clinical diagnosis results as the gold standards and then compared and analyzed the diagnosis results of the two methods. Results Among the 69 suspected pulmonary embolism patients, 43 cases were confirmed, 26 excluded. The sensitivity, accuracy, negative predictive value and the Kappa value of the final clinical diagnosis result of pulmonary Q SPECT/CT in the diagnosis of pulmonary embolism were all higher than those of V/Q planar imaging. While, the diagnostic specificity in those patients with chronic obstructive pulmonary disease (COPD) operated by pulmonary Q SPECT/CT was lower than that of V/Q planar imaging. After adjusting the impact of COPD patients, the specificity of pulmonary Q SPECT/CT improved obviously, and was higher than that of V/Q planar imaging. The consistency of pulmonary embolism detection rate by the two methods was 85%(34/40)and the difference of the detection rate between the two methods was significant (χ2=8.10, P<0.05). Conclusion Pulmonary Q SPECT/CT obviously improved the diagnostic value of pulmonary embolism without COPD, so it should be deliberated whether it takes the place of the V/Q planar imaging.