探讨多层螺旋CT肺血管造影在肺动脉栓塞中的诊断价值

Evaluation of diagnostic values of multislice spiral CT pulmonary angiography in pulmonary embolism

目的:探讨多层螺旋CT肺血管造影在肺动脉栓塞中的诊断价值。方法:回顾性分析79例经多层螺旋CT肺血管造影诊断为肺动脉栓塞患者的临床病例资料,分析比较非危重(33例)和危重(46例)患者CT肺血管造影表现以及CT检测结果。结果:79例肺栓塞患者多层螺旋CT影像学图像显示4 378支肺动脉中有833支(19.0%)肺动脉表现出一定程度的栓塞;肺动脉栓塞患者直接征象主要为中心型、锐角附壁型、钝角附壁血栓型以及完全阻塞型充盈缺损,间接征象主要为肺动脉高压、脑梗死以及胸膜增厚和积液;病情危重患者其CT肺动脉阻塞指数以及中央肺动脉受累率均明显高于病情非危重患者(P<0.05)。结论:多层螺旋CT肺血管造影在诊断肺动脉栓塞方面具有无创、简便、快捷且安全等特点,对评价肺动脉患者病变严重程度上具有重要临床价值。

Objective： To evaluate diagnostic values of multislice spiral CT pulmonary angiography in pulmonary embolism.Methods： The clinical data of 79 patients diagnosed with pulmonary arterial embolization by multi-slice spiral CT pulmonary angiography were retrospectively analyzed. The CT pulmonary angiography manifestations and CT findings of the non-critical（ 33 cases） and critical cases（ 46 cases） were analyzed and compared. Results： The multi-slice spiral CT images of the 79 patients with pulmonary arterial embolization indicated that 833（ 19.0%） pulmonary arteriesamong the 4378 pulmonary arteries showed a certain degree of embolism; the direct signs were central,acute angle attached to the wall,obtuse angle with thrombus and complete obstruction filling defect,and the indirect signs were pulmonary hypertension,cerebral infarction and pleural thickening and effusion; and the pulmonary artery occlusion index and the central pulmonary artery involvement rate were significantly higher in the critical patients than those in the non-criticalones（ P〈0.05）. Conclusions： The multislice spiral CT pulmonary angiography in the diagnosis of pulmonary embolism is noninvasive,simple,fast and safe,and has an important clinical value in the evaluation of pulmonary artery disease severity.