16排快速螺旋CT增强扫描联合D-二聚体检测诊断肺栓塞16例

16-DETECTOR-ROW SPIRAL CT ENHANCE SCANNING COMBINING WITH D-DIMMER IN PULMONARY EMBOLISM DIAGNOSIS

目的评价16排快速螺旋CT（MDSCT）增强肺血管扫描联合D-二聚体检测在肺栓塞早期诊断中的应用价值。方法我院诊断的肺栓塞患者16例采用16排MDSCT检查，30％碘海醇注射液100ml为造影剂，高压静脉推注泵推注，浓度300mgI／ml，速度2．5~3ml／s，用量80～90ml，扫描层厚10mm，螺距系数1．375，MIP及3D显示技术，运用专业软件进行血管重建，同时用乳胶法检测患者血浆D-二聚体。结果16例患者D-二聚体均〉500ng／ml。16排MDSCT增强扫描后显示肺动脉栓塞右肺动脉干7例，左肺动脉干6例，左下肺动脉3例。确诊率迭100％。影像表现为：半月形或环形充盈缺损，完全堵塞及轨道征。结论在临床上患者出现不明原因的呼吸困难，胸闷，胸疼，低血压休克，晕厥，单侧或双侧下肢不对称肿胀，疼痛时，建议及时行血浆D-二聚体及16排MDSCT胸部增强扫描，以尽早确诊肺栓塞。

Objective To evaluate the effect of 16- detector- row spiral CT enhance scanning combining with D- dimmer diagnosis pulmonary embolism. Methods on the 16 patients with pulmonary embolism diagnosis in our hospital, 16 - detector- row performed spiral CT enhance scanning were adopted. 30% iodid mellow injection 100ml and high pressure veinpushing 300mgI/ml were injected at the speed of 2.5 - 3ml/s, volume 80 - 90ml, scanning per 10mm, modulus 1. 375,MIP and 3D vision technique. Vessel rebuild was made through special software vessel, at the same time patients D - dimmer through latex was measured. Results 16 patients had D- dimmer 〉 500ng/mlo 16 - detector- row spiral CT enhance scanning showed 7 right pulmonary artery embolized,6 left pulmonary artery embolized, 3 left- below pulmonary artery embolized. Diagnose rate was 100 %. Image was composed by ：lune or loop ,complete jam and sigh of track. Conclusion When the patients show dyspnea, chest pain, low blood pressure shock, swoon, one side or both sides asymmetry strut, ache,it is necessary to perform D- dimmer and 16 - detector- row spiral CT enhance scanning in time for diagnosis of pulmonary embolism.