128层螺旋CT血管造影在肺动脉栓塞诊断及复查中的应用

Clinical application value of 128-slice spiral computed tomography angiography in the diagnosis and re-examination of pulmonary artery embolism

目的评价128层螺旋CT血管造影在肺动脉栓塞诊断及复查中的应用价值。方法采用触发扫描技术对32例临床怀疑肺动脉栓塞患者行128层螺旋CT肺动脉造影检查,所得容积数据传送至工作站后分别行多平面重建、最大密度投影、容积再现等后处理成像。结果 32例疑似患者中,肺动脉栓塞阳性者21例,复查后,可见栓子数目、形态发生变化。肺动脉栓塞的直接征象为管腔狭窄、阻塞、分支减少及血管腔内的低密度充盈缺损,间接征象为肺梗死灶形成、胸腔积液、肺动脉高压等。结论 128层螺旋CT肺动脉造影能及时、准确、直观地显示栓子部位,是肺动脉栓塞安全、迅速、无创的诊断及复查方法。

Objective To evaluate the diagnosis and re-examination value of 128 slice spiral computed tomography angiography （CTPA） in pulmonary embolism. Methods Thirty-twosuspected pulmonary embolism patients were examined by technique that concentration of contrast medium controled the scanning of 128 slice spiral CT. Volume data was transmitted to the work station and the reconstruction of muhiplanar reformations （MPR）, maximum intensity projection （MIP）, volume rendering （VR） was done. Results Twenty-one cases （21/32） were diagnosedpulmonary embolism （PE）. The changes of embolisms were observed. The direct signs of pulmonary embolism were luminal constriction, emphraxis,branched decreased, intraluminal low D filling defect of blood vessel; while the indirect signs were formation of pulmonary infarction focus, pleural effusion,pulmonary hypertension. Conclusion The CTPA plays an important role in the vivid recognition of thrombosis and sites of thrombosis. This is a safe, quick and non-invasive imagilogic examination for pulmonary embolism diagnosis and re-examination.