多层螺旋CT肺血管造影对肺栓塞解剖分布及形态的评价

The Evaluation of MDCT Pulmonary Angiography in Anatomic Distribution and Shape of Pulmonary Embolis

目的评价肺栓塞(PE)在多层螺旋CT肺血管造影(CTPA)上的解剖位置分布及形态特点。资料与方法75例PE患者作CTPA,由两名有经验的放射科医师阅片,根据血栓在最大肺血管分支内的位置分为5型:肺动脉干型、左或右肺动脉型、肺叶动脉型、肺段动脉型和肺亚段动脉型;同时观察血栓在血管内的形态。结果75例PE中,肺动脉干型6例(8%),左或右肺动脉型12例(16%),肺叶动脉型28例(37.3%),肺段动脉型19例(25.3%)和肺亚段动脉型10例(13.3%)。PE形态为:中央型51例(68%),附壁型7例(9.3%),闭塞型17例(22.7%)。结论CTPA可准确、清晰地显示PE的解剖位置分布及形态,能提高小PE的检出率,为临床治疗方案的选择提供依据。

Objective To evaluate the features of the anatomic distribution and shape of pulmonary embolism on muhidetector row helical CT （MDCT） pulmonary angiography（CTPA）. Materials and Methods 75 eases with PE were performed with CTPA. Two experienced radiologists evaluated the CT images .regarding the presence or absence, the anatomic distribution and shape of pulmonary emboli. The patients were categorized into five classes according to the largest pulmonary vessel in which PE could be seen： main pulmonary trunk, left or right main pulmonary branch, lobar, segmental, or suhsegmental artery. The shape of pulmonary emboli was recorded. Results Of 75 patients, the largest pulmonary arterial branch with PE was pulmonary trunk in 6 （8%）, left or right pulmonary artery in 12 （ 16% ）, lobar in 28 （37.3%）, segmental in 19 （25.3%） and subsegmental in 10 （ 13.3% ） patients respectively. Proportion of patients with the center, mural and ccclusion type thrombi emboli was 68% （51/75）, 9.3% （7/75） and 22.7% （17/75） respectively. Conclusion CTPA can accurately show the anatomic distribution and shape of pulmonary emboli, and small pulmonary artery emboli can be seen in a relatively high proportion of patients. CTPA is hdpful to sdect the strategy of treatment.