64排螺旋CT扫描对肺栓塞的诊断价值分析

The value of the 64 row spiral CT scan in the diagnosis of pulmonary embolism

目的评价64排螺旋CT肺动脉血管造影(CTPA)对肺栓塞(PE)的诊断价值。方法对临床疑诊急性PE的72例患者进行CTPA检查,并进行多平面重建(MPR)、最大密度投影(MIP)及容积重建技术(VR)。结果 72例患者中确诊为PE患者29例,共累及476处肺动脉及分支,其中,右肺动脉主干36处,左肺动脉主干42处,肺叶动脉157处,肺段动脉203处,亚段动脉38处。CTPA征象分为直接和间接征象,直接征象:肺动脉主干或分支内混合性、附壁性、中心性充盈缺损;间接征象:局限性肺纹理稀疏,肺动脉高压,右心室增大,胸腔积液等。结论 64排CTPA具有准确、快速、无创伤等优点,可立体、直观地观察到肺动脉血栓的大小、分布及范围,并可观察患者的肺内间接改变,是临床诊断及观察疗效的首选方法。

Objective To evaluate the value of the 64 row spiral CT pulmonary angiography（CTPA） in the diagnosis of pulmonary embolism（PE）.Methods Seventy two cases of patients with clinically suspected acute PE were examined by CTPA,and multiple plane reconstruction（MPR）,maximum intensity projection（MIP） and volume rendering technique（VR）.Results In 72 patients,29 cases were confirmed with pulmonary embolism,476 pulmonary arteries and branches were confirmed including 36 right main pulmonary arteries,42 left pulmonary arteries,157 lobar arteries,203 pulmonary arteries,and 38 inferior segmental arteries.CTPA signs were divided into direct and indirect signs,direct signs：pul monary trunk or branch mixed,mural,central filling defect;indirect signs：localized lung-marking sparse,pulmonary hy pertension,right ventricular enlargement,pleural effusion.Conclusion 64 row CTPA has the advantages of accurate,rapid,noninvasive,three-dimensional,intuitive observed the size,distribution and range of pulmonary artery thrombosis,and can be observed in patients with pulmonary change,is the preferred method for clinical diagnosis and observation of curative effect.