肺动脉栓塞并发肺梗塞的螺旋CT征像分析

Analysis of CT findings for pulmonary embolism complicated with pulmonary infarction

目的:探讨肺动脉栓塞(PE)并发肺梗死(PI)的CT诊断价值。方法:回顾性分析36例肺栓塞患者CT增强扫描表现。结果:36例增强扫描显示段以上肺动脉栓塞268条,局限性肺纹理稀少17例,肺动脉增粗18例,支气管动脉扩张21例,实变尖端见迂曲增粗血管影21例,胸腔积液25例。肺内实变分三型:胸膜下型、楔形实变型、大片实变型。下叶肺动脉栓塞较上叶更易形成肺内实变。并发肺梗塞20例,呈宽基底楔形实变,中心不强化,其间夹杂含气正常肺组织为特征。结论:CT对肺动脉栓塞的诊断及鉴别肺出血和肺梗塞具有较高价值。

Objective： To explore the value of spiral cr in the diagnosis of pulmonary embolism complicated with pulmonary infarction. Methods：＇Ihe contrast enhancement CT manifesfafions of 36 cases with pulmanary embolism were analysed retrospectively.Results：268 blood vessels with pulmonary embolism were found in 36 eases. On CT scan, mosaic oligemia can be seen in 17 caces, the dilatation of central pulmonary arteries was found in 18 cases; the bronchial artery appears in 21 cases, enlarged vessels at the apex of consolidation in 21 caces and, pleural effusions in 25 caces. Seventy-seven percent, （60/78） of parenchymal opacities were in the lower lobes. Fiftysix percent （20/36） of patients with PE had pulmonary infarction. The parenchymal opacities were divided into 3 kinds according to the shapes： peripheral parenchymal opacities under pleura,parenchymal density with truncated apex, and ground glass opacity. Conclusion： CT examination is significantly valuable to the diagnosis of pulmonary embolism and the differentiation between hemorrhagic pulmonary atelectasis with PI.