64层螺旋CT肺动脉造影在肺动脉栓塞诊断中的价值

THE VALUE OF 64-MULTI-SLICE CT PULMONARY ARTERIOGRAPHY IN THE DIAGNOSIS OF PULMONARY EMBOLISM

目的探讨64层螺旋CT肺动脉造影（CTPA）在肺动脉栓塞诊断中的临床应用价值。方法行CTPA检查确诊肺栓塞病人49例,进行容积再现（VRT）、多平面重建（MPR）和最大密度投影（MIP）重建处理并计算CT肺动脉阻塞指数。结果 CTPA扫描肺动脉主干、左右肺动脉及叶、段、亚段动脉显示良好,显示受累肺动脉240条,其直接征象为肺动脉血管内充盈缺损,间接征象包括肺梗死、肺野少血征、胸腔积液等。CT肺动脉阻塞指数为0.375-0.825。结论 CTPA能清楚地显示肺栓塞的部位、范围、局部管腔狭窄程度及其他间接征象,并可以此判断肺栓塞的严重程度,为临床选择治疗方法、观察疗效及判定预后提供必要的帮助。

Objective To evaluate the clinical value of 64-multi-slice CT pulmonary arteriography（CTPA） in the diagnosis of pulmonary embolism（PE）. Methods The volume-rendering technique（VRT）,multiple-plane reconstruction（MPR）,and maximum intensity projection（MIP） were conducted in 49 PE patients confirmed by CTPA,and PE CT index calculated.Results The main pulmonary trunk,left or right pulmonary branches,and lobar,segmental or subsegmental pulmonary arteries were very well displayed,of which,240 pulmonary arteries were involved.The direct sign was filling-defect of the artery,and the indirect signs included pulmonary infarction,pulmonary ischemia,and pleural effusion.CT index of pulmonary obstruction was0.375-0.825. Conclusion The CTPA can clearly display the location,range,degree of vessel stricture,and other indirect signs of pulmonary embolism,which can be used to judge the severity of the condition,and provide an essential help to selection of therapies,assessment of curative effect and prediction of prognosis of this disease.