多层螺旋CT及其图像后处理技术在诊断急性肺栓赛中应用比较

Application of Multi-slice Spiral CT and Its Image Postprocessing Techniques in the Diagnosis of Acute Pulmonary Embolism

目的研究多层螺旋CT(MSCT)图像后处理技术在肺栓塞诊断中的应用价值。方法选取我院2015年1月-2016年1月38例经CT肺血管成像(CTPA)确诊的肺栓塞患者,采用MSCT对患者先行常规动脉增强扫描,观察对肺动脉及栓子的显示效果;采用MSCT图像后处理技术将所得扫描图像进行多平面重组(MPR)、最大密度投影(MIP)及容积再现(VR)处理,进一步观察肺动脉各分支及栓子的显示效果,并与单纯MSCT扫描结果比较。结果 38例肺栓塞患者均成功完成检查,常规MSCT共显示362支肺动脉分支受累,而经过图像后处理后共发现385支肺动脉分支受累,其中主肺动脉8支,左右肺动脉35支,肺叶动脉78支,段动脉218支,亚段动脉46支;经MPR、MIP、VR图像处理后,能较为清晰的观察肺动脉分支充盈缺损及其他征象;385支受累肺动脉分支中MPR显示97.14%(374/385)高于MIP(362/385)、VR92.73%(357/385),差异具有统计学意义(P<0.05)。结论常规MSCT扫描后经过图像后处理技术能进一步准确观察栓子和肺动脉分支受累情况,通过征象表现对指导临床诊断具有重要作用;MPR在亚段及其以下肺动脉分支栓子的显示效果明显优于MIP、VR。

Objective To study the application value of multi-slice spiral CT （MSCT） image postproeessing techniques in the diagnosis of pulmonary embolism （PE）. Methods A total of 38 pauents with PE diagnosed by CT pulmonary angiography （CTPA） in our hospital during January 2015 - January 2016 were enrolled in the study. All patients received conventional arterial enhancement scanning with MSCT, the display of pulmonary arteries and emboli was observed. The amages obtained through MSCT image postprocessing techniques were rreated with multipianar reconstruction （MPR）, maximum intensity prodecuon （MIP） and volume rendering （VR）, and the display of pulmonary arteries and emboli was observed again. The results were compared with those of pure MSCT scan. ResultsAll subjects successfully completed the examination. Routine MSCT showed a total of 362 branches of pulmonary artery involvement, and image postprocessing showed a tota] of 385 branches of the pulmonary artery involvement, including 8 main pulmonaW arteries. 35 left and right pulmonary arteries. 78 lobar arteries, 218 segmental arteries and 46 sub segmental arteries. After MPR. MIP and VR, image processing, the branch filling defects and other signs of pulmonary artery can be observed clearly. Among 385 branches of pulmonary arterv inw）lvement, there were 97.14% （374/385） displayed by MPR. more than （362/385） bv MIP and 92.73% （357/385） by VR （P〈0.05）. Conclusion After routine MSCT scanning, image postprocessing techniques can accurately display emboli and puhnonary artery involvement, and the signs play an important role in clinical diagnosis. The display of sub segmental and lower pulmonaW artery, emboli by MPR is better than MIP and VR.