双源CT肺动脉成像在肺动脉栓塞诊断中的应用价值

Application of dual-source CT pulmonary angiography in the diagnosis of pulmonary embolism

目的:探讨双源CT肺动脉成像对肺动脉栓塞(PE)的诊断价值。方法:对58例临床拟诊为PE的患者行双源CT肺动脉成像,总结PE的直接、间接征象及分型,并比较MPR、MIP、VR和CTVE对肺动脉栓子的显示效果。结果:直接征象:58例中45例诊断为PE,共发现栓子658支(中心型170支,偏心型208支,附壁型74支,完全闭塞型206支)。间接征象:马赛克征13例,胸腔积液27例,肺动脉高压7例,肺梗死18例。MPR检出栓子658支,MIP检出584支,VR及CTVE对栓子的显示效果较差,分别为249支和75支。MIP、VR及CTVE对栓子的显示效果低于MPR,差异有统计学意义(P<0.05)。结论:双源CT肺动脉成像能够方便、快捷、清楚地显示肺动脉栓子,对诊断PE有重要价值;MPR、MIP、VR和CTVE是显示栓子的重要辅助方法,以MPR显示效果最佳。

Objective：To explore the value of dual-source CT angiography of pulmonary arteries in the diagnosis of pulmonary embolism.Methods：58 patients suspected of having pulmonary embolism were examined with dual-source CT pulmonary angiography.The effects of imaging in displaying pulmonary embolism on MPR,MIP,VR and CTVE were compared.The direct signs,the indirect signs and types were analyzed.Results：45 cases with pulmonary embolism were diagnosed.A total of 658 emboli were found by dual-source CT,170 of which were central type,208 were eccentric type,74 were mural type,and 206 were complete occlusion type.Indirect signs included mosaic sign（13 cases）,pleural effusion（27 cases）,pulmonary artery hypertension（7 cases）,and pulmonary infarct（18 cases）.658 emboli were found on MPR,584 on MIP,the effect of VR and CTVE were not good（249 and 75 emboli were found）.MIP,VR and CTVE were obviously inferior to MPR（P0.05）.Conclusion：The dual-source CT pulmonary angiography is a convenient,fast and reliable method for demonstration of pulmonary embolism.MPR,MIP,VR and CTVE play an important role in the diagnosis of pulmonary embolism,and MPR is the best among them.