双源CT在肺段动脉栓塞诊断中的应用价值

Application Value of Shuang Yuan CT in the Diagnosis of Pulmonary Arterial Embolism

目的:探讨双源CT在肺段动脉栓塞诊断中的应用价值。方法:纳入2015年2月-2020年2月收治的肺段动脉栓塞患者60例,所有患者均接受64排螺旋CT、双源CT检查,双源CT设为研究组,64排螺旋CT设为对照组,对比64排螺旋CT与双源CT之间的诊断差异。结果:CT检查显示肺段动脉栓塞的影像学图像可分为直接与间接征象。直接征象:其血管充盈时明显出现缺损;间接征象:患者的肺部纹理出现明显局限性。若患者存在血管栓塞,则造影剂周围环绕较为明显,其轨道征象会受到切面影响,表现为中心性血管充盈缺损。在检查过程中,若发现患者血管壁附着血栓,则造影剂呈现不规则性充盈,出现血管内向心性充盈缺损。若肺动脉血管远端未见造影剂,且血管处这段未出现规律性,则表示为完全栓塞。研究组共有58例患者确诊为肺段动脉栓塞,真阳性58例、真阴性2例,假阳性1例、假阴性2例。与对照组的诊断准确率、特异性、敏感性相比,其结果无明显差异(P>0.05)。结论:肺段动脉栓塞诊断中选择双源CT,诊断准确率较高,与64排螺旋CT诊断相比,一次扫描可获得平扫、增强及碘图等多种数据,较常规肺动脉成像更利于栓塞的检出,其诊断准确率、特异性、敏感性无显著差异,且该诊断方法无创,患者接受程度高,可作为肺段动脉栓塞首选的诊断方法。

Objective:To explore the application value of Shuang Yuan CT in the diagnosis of pulmonary arterial embolism.Methods:Sixty patients with pulmonary arterial embolism admitted from February 2015 to February 2020 were enrolled.All patients received 64-slice spiral CT and Shuang Yuan CT,and received Shuang Yuan CT as the study group and 64-slice spiral CT as the control group.The diagnostic differences between 64-slice spiral CT and Shuang Yuan CT were compared.Results:CT shows that the imaging images of pulmonary arterial embolism can be divided into direct and indirect signs.Direct sign:the defect appears obviously when the blood vessels are filled;Indirect sign:The pulmonary texture of the patient is obviously limited.If the patient has vascular embolism,the surrounding of the contrast medium is obvious,and its orbital sign will be affected by the section,showing a central vascular filling defect.During the examination,if thrombus is found attached to the blood vessel wall of the patient,the contrast medium will show irregular filling,and there will be an inward filling defect.If there is no contrast medium at the distal end of pulmonary artery and there is no regularity at the blood vessel,it means complete embolism.A total of 58 patients in the study group were diagnosed as pulmonary arterial embolism,including 58 cases of true positive,2 cases of true negative,1 case of false positive and 2 cases of false negative.Compared with the control group,the diagnostic accuracy,specificity and sensitivity showed no significant difference(P>0.05).Conclusion:Shuang Yuan CT has higher diagnostic accuracy in the diagnosis of pulmonary arterial embolism.Compared with 64-slice spiral CT,it can obtain more data such as plain scan,enhanced scan and iodine chart in one scan.Compared with conventional pulmonary artery imaging,it is more conducive to the detection of embolism.There is no significant difference in diagnostic accuracy,specificity and sensitivity.Moreover,this diagnostic method is non-invasive and highly accepted by patients,and can be used as the preferred diagnostic method for pulmonary arterial embolism.