640层CT肺减影成像联合肺动脉CTA诊断急性肺栓塞的初步探究

Preliminary study on 640-slice CT lung subtraction imaging combined with pulmonary CTA in the diagnosis of acute pulmonary embolism

目的:分析对急性肺栓塞采用640层CT肺减影成像联合肺动脉CTA诊断的临床价值。方法:选取2018年10月—2019年4月内江市第一人民医院诊疗的肺栓塞患者76例,患者采用肺动脉CTA诊断后进行640层CT肺减影技术重建。比较单一诊断及联合诊断的诊断效能。结果:按标准测得肺部血栓共计326个,其中35个位于主干,76个位于叶,133个位于段,82个位于亚段及以下,对两种诊断方式的灵敏度进行比较,在主干、叶、段处的栓塞肺动脉CTA诊断方式的灵敏度分别为100.0%(35/35)、97.4%(74/76)、94.7%(126/133),640层CT肺减影成像联合肺动脉CTA诊断方式的灵敏度分别为100.0%(35/35)、98.7%(75/76)、97.7%(130/133),两种诊断方式的灵敏度比较无显著差异(P> 0.05);640层CT肺减影成像联合肺动脉CTA诊断在亚段及以下与总的灵敏度分别为95.1%(78/82)、97.5%(318/326),均显著高于肺动脉CTA诊断的82.9%(68/82)、92.9%(303/326)(P <0.05)。结论:采用肺动脉CTA联合640层CT肺减影成像诊断主干、叶、段处的栓子诊断效能均较高,但640层CT肺减影成像联合肺动脉CTA诊断亚段及以下的栓子具有更高的诊断效能。

Objective To analyze the clinical value of 640-slice CT lung subtraction imaging combined with pulmonary CTA in the diagnosis of acute pulmonary embolism.Methods 76 patients with pulmonary embolism diagnosed and treated in The First People’s Hospital of Neijiang from October 2018 to April 2019 were selected for the study.The patient underwent 640-slice CT lung subtraction reconstruction after pulmonary artery CTA diagnosis,to compare the diagnostic efficiency of single diagnosis and combined diagnosis.Results A total of 326 pulmonary thrombi were measured according to the standard,of which 35 were located in the main trunk,76 were located in the lobes,133 were located in the segment,and 82 were located in the subsegment and below,compare the sensitivity of the two diagnostic methods,embolism at the trunk,lobes,and segment the sensitivity of pulmonary artery CTA diagnosis method is 100.0%(35/35),97.4%(74/76),94.7%(126/133).The sensitivity of 640-slice CT lung subtraction imaging combined with pulmonary artery CTA diagnosis method is 100.0%(35/35),98.7%(75/76),97.7%(130/133),there was no significant difference in sensitivity between the two diagnostic methods(P > 0.05).The sensitivity of 640-slice CT pulmonary subtraction imaging combined with pulmonary CTA in the diagnosis of sub segment and below was 95.1%(78/82) and 97.5%(318/326),which was significantly higher than 82.9%(68/82) and 92.9%(303/326) of pulmonary artery CTA(P < 0.05).Conclusion Pulmonary artery CTA combined with 640-slice CT pulmonary subtraction imaging has high diagnostic efficiency in the diagnosis of emboli at the trunk,lobes and segment,but 640-slice CT lung subtraction imaging combined with pulmonary CTA has higher diagnostic efficiency in diagnosing emboli of sub-segment and below.