先天性心脏病合并脓毒性肺栓塞患者的多层螺旋计算机断层扫描表现

Multisliecs helieal computed tomography manifestations in patients with congenital heart disease complicated with septic pulmonary embolism

目的探讨多层螺旋计算机断层扫描(multisliecs helieal computed tomography,MSCT)在先天性心脏病合并脓毒性肺栓塞(congenital heart disease complicated with septic pulmonary embolism,CHD-SPE)患者中的表现及其诊断价值。方法回顾性分析12例CHD-SPE患者的MSCT表现。结果(1)计算机断层扫描(computed tomography,CT)平扫12例患者均见双肺多发病灶,共167处,结节影伴空洞、结节影、楔形影及斑片浸润影分别54、21、14、78处;132处病灶位于胸膜下。(2)9例患者同时行CT增强扫描,均显示先天性心血管畸形,4例见心血管内赘生物,1例肺动脉充盈缺损、中断呈瘤样扩张。(3)肺部100处病灶见血管滋养征,滋养血管为肺动脉、肺静脉及肺动静脉分别69、25、6处。结论MSCT能显示先天性心血管畸形及双肺多发、形态多样、外周多发及滋养血管征的特征性肺部表现,对CHD-SPE有一定提示意义,对临床治疗有指导性意义。

Objectives To investigate the multisliecs helieal computed tomography(MSCT)manifestations and diagnostic value in patients with congenital heart disease complicated with septic pulmonary embolism(CHD-SPE).Methods MSCT manifestations of 12 patients with CHD-SPE were retrospectively analyzed.Results(1)A total of167 lesions were found in 12 patients in bilateral lungs on computed tomography(CT)plain scans.Among them,nodules with cavities,nodules,wedge shadows and patch infiltrates were 54,21,14,78,respectively;132 lesions were sub-pleura.(2)Congenital cardiovascular malformations were seen by enhanced CT in 9 patients,cardiovascular vegetation in 4 patients were observed,1 patient showed pulmonary artery filling defect and an eurysmal-liked expansion.(3)Enhanced CT of 9 patients showed 100 lesions with nourished vessels,69 lesions were pulmonary artery,25 lesions were pulmonary vein and 6 lesions were pulmonary arteriovenous.Conclusions MSCT can demonstrate congenital cardiovascular malformations and multiple,diverse forms and peripheral lung lesions,as well as the nourished vessels.Combined with clinical features,MSCT can confirm the diagnosis of CHD-SPE and provide guidance for treatments.