多层螺旋CT肺动脉造影对肺动脉栓塞的诊断价值(附15例报告)

The value of multi-slice spiral CT pulmonary angiography in diagnosing plmonary embolism:Report of 15 cases

目的评价多层螺旋CT血管造影（MSCTA）在诊断肺动脉栓塞（PE）中的价值。方法对15例经MSCT确诊肺动脉栓塞患者进行回顾性分析。结果多发肺动脉栓塞10例，其中双侧多发7例，左侧多发I例，右侧多发2例；单发肺动脉栓塞5例，其中肺动脉干2例，叶动脉1例，段动脉2例。肺动脉栓塞的直接征象包括肺动脉主干或其分支的充盈缺损、肺动脉段面细小及管腔内不均匀密度减低；间接征象可以有肺内“马赛克征”、楔形影或索条状影、胸腔积液或胸膜肥厚。结论多层螺旋CT肺动脉造影是诊断肺动脉栓塞的快速、有效、无创伤的诊断方法，尤其对亚段肺动脉栓塞是一种先进的方法，可以代替肺动脉造影，成为诊断肺动脉栓塞的首选方法。

Objective To evaluatethe the effectiveness of multiple spiral CT angiography （MSCTA） in diagnosis of pulmonary embolism. Methods Fitteen patients with pulmonary embolism diagnosed with MSCTA were retrospectively analyzed. Results Ten patients were diagnosed as multiple pulmonary embolism, among them, 7cases were bilaterally involved, PE located only at the left side in one patient, and at the right side in two patients. Five patients were diagnosed as solitary pulmonary embolism, among them the locations were within the pulmonary trunk in two patients, within the lobular arterial branch in one patient, and within the segmental branch in two patients. Direct signs of pulmonary embolism included filling defect within pulmonary trunk or its braches; diminution of the pulmona- ry artery lumen at its cross section images, and heterogeneous decrease of attenuation within the lumen. Indirect signs included＂mosaic sign＂, wedge or linearshaped opacities in lung,pulmonary effusion or plural thickening. Conclusion MSCTA is a fast, effective, and noninvasive diagnostic method for PE. It may replace the pulmonary angiography （DSA）. It will be the gdden standard for diagnosis of pulmonary embolism.