多排CT对肺动脉栓塞和下肢深静脉血栓检出的研究

Clinical study of multi-slice spiral CT in the combined detection of pulmonary embolism and lower extremity deep vein thrombosis

目的:评价运用CT肺动脉造影和下肢CT静脉造影(CTVPA)两种方法对肺动脉栓塞(PE)和下肢深静脉血栓(DVT)检出的应用价值。方法:对38例临床怀疑PE的患者行CTVPA检查,分析其影像表现,并探讨其应用价值。结果:38例患者中PE24例,下肢DVT11例。PE主要表现为血管腔内充盈缺损和同侧肺野内病变。下肢DVT主要表现为下肢深静脉管腔内充盈缺损、静脉增粗和患肢软组织肿胀。对于栓子的显示,多层面容积重建(MPVR)优于最大密度投影(MIP)和容积再现(VR)。结论:多排CT(MSCT)联合运用CT肺动脉造影和CTVPA两种方法对PE和下肢DVT检出有很大的应用价值,可作为临床怀疑PE的患者首选检查方法。

Objective To evaluate the usefulness of the combined examination （CTVPA） of CT pulmonary angiography （CTPA） and CT venography （CTV） in the diagnosis of pulmonary embolism （PE） and lower extremity deep vein thrombosis （DVT）. Methods Thirty-eight patients with suspected PE underwent CTVPA. The results were retrospectively assessed. Results Twenty-four patients were diagnosed as PE and 11 as DVT. The appearances of PE were filling defect in pulmonary arteries and had changes in the same side lung field. The appearances of DVT were filling defect in veins, lumens dilation and soft tissue swelling in the lower extremity. Regarding the detection of the embolus, multiplanar volume reconstruction （MPVR） was better than maximum intensity projection （MIP） and volume rendering （VR）. Conclusions CTVPA could be used as a first selective technique in the diagnosis of suspected PE.