螺旋CT肺血管造影诊断周围性肺栓塞的实验研究

Experimental Study of HCTPA in Diagnosing Peripheral Pulmonary Embolism

目的 :探讨螺旋CT肺血管造影 (HCTPA)诊断周围性肺栓塞的价值 ,提高对肺栓塞HCTPA表现的认识。材料和方法 :8只犬于DSA下经导管注入直径 2～ 4mm、长 1cm的明胶海绵条后复制为单侧周围性肺栓塞动物模型 ,进行HCTPA检查 ,观察栓塞肺动脉之HCTPA的表现 ,分析HCTPA诊断肺栓塞的敏感性。结果 :栓塞侧肺野共观察到亚段以上肺动脉76支 ,DSA发现 2 6支栓塞肺动脉 ,均位于肺段及以下水平动脉。HCTPA共诊断了 2 0支肺动脉栓塞 ,其中 2支为误诊 ,敏感性为 69.2 % ,特异性为 96%。栓塞肺动脉于HCTPA主要表现为完全或不完全截断。结论 :HCTPA可以对周围性肺栓塞做出可靠的诊断 ,是诊断肺栓塞的理想方法。

Purpose: To investigate the value of HCTPA in diagnosing peripheral pulmonary embolism(PPE). Materials and Methods: 8 dogs under went PPE animal models by introducing gelatin sponge of 2～4mm in diameter and 1cm long into unilateral pulmonary arteries through a catheter under DSA, then HCTPA examination was done. The manifestation of embolic arteries and the sensitivity of HCTPA in diagnosing pulmonary embolism were analyzed. Results: A total of 76 arteries were observed in embolic lungs.26 embolic arteries were found on DSA, all of which located at segmental and sub segmental branches. 20 arteries were diagnosed as embolism on HCTPA, including 2 arteries misdiagnosed. The sensitivity of HCTPA was 69.2%, and the specificity 96%. The embolic arteries manifested as absolute or partial obstruction. Conclusion: With high reliability, HCTPA is an ideal method in diagnosing PPE.