多层螺旋CT及其图像后处理技术诊断肺栓塞的价值

The application of multi-slice CT and image post processing techniques in diagnosing of pulmonary embolism

目的通过多层螺旋CT多种重组方法对肺栓塞的影像进行观察,评价多层螺旋CT多种重组方法在诊断肺栓塞中的应用价值。方法回顾性分析45例经CT肺血管成像(CTPA)确诊肺栓塞病人的资料,应用最大密度投影(MIP)、多平面重组(MPR)、容积再现(VR)观察3种方法对肺动脉及其栓子的显示效果,并进行比较分析。结果 MPR影像显示亚段及其以下肺动脉分支血栓的显示率优于MIP、VR影像,其差异具有统计学意义(P<0.05)。对于肺动脉6级分支内是否有栓子各种方法显示均差。结论 MPR、MIP、VR3种重组方法以MPR显示最清晰准确,但缺乏立体感;MIP、VR对于大的分支显示比较立体、直观。MPR结合MIP、VR影像更能明确定位及定性诊断肺栓塞。

Objective To characterize the pulmonary embolism （PE） on multi-slice CT pulmonary angiography, and to evaluate the role of multi-slice CT pulmonary angiography （CTPA） in the diagnosis of PE. Methods Forty-five patients with PE confirmed by CTPA were retrospective analyzed. Images were reconstructed with maximal intensity projection （MIP）, multiple planar reconstruction （MPR） and volume rendering technique （VRT）. The display of pulmonary arteries and the ability of detecting embolisms were compared among the three different reconstruction techniques. Results MPR images showed superiority to MIP and VRT images in displaying embolisms （P〈0.05）. Conclusion MPR images were better than those of MIP and VRT, but provided poor three-dimensional information; MIP and VRT were more straightforward than MPR in displaying large branches of pulmonary artery. MPR combined with MIP and VRT could help to accurately establish PE diagnosis.