目的探讨增强核磁共振灌注扫 描技术(MRPP)与增强核磁共振肺动脉造影 术(MRPA)对于肺动脉栓塞患者诊断的敏感 度与特异度差异，比较两者诊断的临床价 值。方法 对我院自2010年12月至2013年 6月期间收治的32例确诊肺动脉栓塞患者 的临床资料进行分析。均对其行增强核磁 共振灌注扫描术与增强核磁共振肺动脉造 影术，其中10例患者同时行核素肺灌注扫 描，另有7例患者在经过溶栓治疗以后， 对其进行MRPP以及MRPA的复查。检查时在 患者的异常区域以及上部、中部以及下 部肺动脉病变区域设置感兴趣区(ROI)， 对信号-时间曲线、信号强度(SI)进行测 量，从而获得血流灌注高峰时段信号强度 的变化率(TROS)。结果 对上述32例肺动 脉栓塞患者行MRPA，发现共有137条肺动 脉出现闭塞，行MRPP后发现共有125个肺 部血流灌注异常区域和MRPA结果吻合，吻 合率为91.24%。32例肺动脉栓塞患者在 MRPP检查中发现有57个肺动脉段合并段以 远及段的动脉栓塞。10例同时行核素肺灌 注扫描患者结果表明，共有81个肺动脉段 灌注缺损，而此时MRPA检查结果显示77个 肺段受到累及，敏感度为95.06%，MRPP 检查结果显示73个肺段受累，敏感度为 90.12%。结论 MRPP对于肺动脉诊断的敏 感度显著低于MRPA，MRPP以及MRPA都有可 以有效观察区别肺动脉栓塞的低灌注区和 灌注缺损区。

Objective To investigate the enhancement scanning technique of nuclear magnetic resonance perfusion (MRPP) with enhanced magnetic resonance pulmonary angiography (MRPA) for the diagnosis of pulmonary embolism in patients with sensitivity and specificity differences, compare the clinical value of diagnosis. Methods to analyse the clinical data in our hospital from 2010 December to 2013 June period of 32 patients with pulmonary embolism patients. On the enhanced magnetic resonance perfusion scanning and enhanced magnetic resonance pulmonary artery angiography, including 10 patients who underwent simultaneous radionuclide lung perfusion scan, and another 7 patients after thrombolytic therapy, MRPP and MRPA review of the. When the examination is arranged in the abnormal regions of patients, as well as the upper middle and lower lung artery lesion area of region of interest (ROI), the signal time curves, signal strength (SI) measurements were carried out, thus obtaining the blood perfusion changes of peak signal intensity ratio (TROS). Results Of the 32 cases of pulmonary embolism were examined by MRPA, found a total of 137 pulmonary artery occlusion, after MRPP found a total of 125 pulmonary blood flow perfusion abnormality of regional and MRPA results agree, agreement rate was 91.24%. 32 cases of pulmonary embolism in the MRPP examination found that arterial embolization of pulmonary artery segment with 57 subsegments and segment. 10 patients also underwent radionuclide lung perfusion scan results showed that a total of 81 patients, a pulmonary segmental perfusion defects, while MRPA showed 77 lung segments are involved, the sensitivity was 95.06%, MRPP showed 73 segmental involvement, the sensitivity is 90.12%. Conclusion MRPP for the diagnosis of pulmonary sensitivity was significantly lower than that of MRPA, MRPP and MRPA have can effectively observe the difference of pulmonary embolism of low perfusion and perfusion defect region.