CT肺动脉造影与MR肺动脉成像在肺栓塞评估中的准确性比较

Comparison of the accuracy of CT pulmonary arteriography and MRI in the clinical evaluation of PE

目的探讨CT肺动脉造影与磁共振肺动脉成像在肺栓塞(pulmonary embolism,PE)临床评估中的准确性。方法选取28只成年健康长毛兔制作PE模型,均行磁共振肺动脉成像(magnetic resonancepulmon aryangiography,MRPA)及CT肺动脉造影(computed tomography pulmonary angiography,CTPA)检查,按照肺动脉血管直径将其分级比较,比较血管清晰度,根据PE阳性率分析2种方法评估的准确性。结果Ⅰ级血管直径检出比较2种诊断方式无明显差异(P>0.05);CTPA在Ⅱ级血管直径方面明显大于MRPA,MRPA检出Ⅲ、Ⅳ级血管直径明显较大,差异具有统计学意义(P<0.05);CTPA检出Ⅰ、Ⅱ、Ⅲ、Ⅳ级血管清晰度均明显较高,差异具有统计学意义(P<0.05);经病理学检查,28只长毛兔中21只确诊为PE,占比75.00%,MRPA检查PE阳性率为60.71%(17/28);CTPA检出PE阳性率为67.85%(19/28),与病理诊断结果差距小于MRPA检查(P<0.05)。结论MRPA与CTPA检查在PE诊断应用中各具优势,CTPA相较于MRPA诊断准确性更高,临床可普遍使用,MRPA则可作为CTPA检查的有益补充。

Objective To evaluate the accuracy of CT pulmonary angiography and MRI in PE.Methods Twenty-eight healthy adult long-haired rabbits were selected to make pulmonary embolism(PE)model,and all of them were examined by magnetic resonance pulmonary angiography(MRPA)and computed tomography pulmonary angiography(CTPA).The classification was compared according to the pulmonary artery diameter,and the vascular clarity was compared.The accuracy of the three methods was evaluated according to the analysis of PE positive rate.Results GradeⅠvascular diameter detection compared two methods for diagnosis had no obvious difference(P>0.05);CTPA in levelⅡin blood vessel diameter was greater than MRPA obviously,levelⅢ,Ⅳblood vessel diamete by MRPA was larger,the differences were statistical significance(P<0.05);CTPA detection of levelⅠ,Ⅱ,Ⅲ,Ⅳvascular definition were significantly higher,the differences have statistical significance(P<0.05);After pathological examination,21 of the 28 long-haired white rabbits were diagnosed with PE,accounting for 75.00%,and the positive rate of PE in MRPA examination was 60.71%(17/28).There were 19 PE positive cases detected by CTPA,accounting for 67.85%,which was less than that of MRPA(P<0.05).Conclusion MRPA and CTPA examination have their own advantages in the application of PE diagnosis.Compared with MRPA,CTPA is more accurate in diagnosis and can be widely used in clinic.MRPA can be used as a beneficial supplement to CTPA examination.