多层螺旋CT在肺动脉栓塞诊断中的应用价值分析

Analysis of the Application Value of Multi-slice Spiral CT in Diagnosis of Pulmonary Embolism

目的:探讨研究多层螺旋CT在肺动脉栓塞诊断中的应用价值.方法:采用64层螺旋CT检查诊断28例疑似为肺动脉栓塞患者,以非离子碘比醇为造影剂,获得扫描定位像,扫描完毕用计算机分别进行0.75mm、1.5mm、3.0mm、5.0mm层厚三维图像重建,观察肺动脉叶、段、亚段肺动脉支数,同时记录有无肺动脉栓子.结果:28例患者均诊断为肺动脉栓塞,主肺动脉在四组不同层厚的图像中显示率为100%,四组不同层厚组叶动脉显示率比较无显著性差异(P>0.05),段、亚段、5级、6级动脉显示率相比具有显著性差异(P<0.05);左肺下叶栓塞血管数明显多于右肺上叶、右肺中叶、右肺下叶和左肺上叶,0.75mm和1.5mm层厚图像叶、段、亚段动脉显示及栓塞血管数基本一致,优于3.0mm和5.0mm层厚;四组不同层厚图像显示不同肺动脉平均栓子数显示率,0.75mm层厚组和1.5mm层厚组比较无显著性差异(P>0.05),明显优于3.0mm和5.0mm层厚组.结论:1.5mm层厚重建64层螺旋CT肺动脉造影能有效提高肺动脉和肺动脉栓子的显示率,提高肺动脉栓塞的诊断效率和准确度,有重要的临床诊断价值.

Objective:To explore the application value of multi-slice spiral CT in diagnosis of pulmonary embolism. Methods:Using 64-slice spiral CT to diagnose 28 cases of suspected pulmonary embolism patients. Nonionic Io-bitridol was used as contrast agent to gain the scanning and positioning image. After scanning, we used computer to reconstruct the three-dimensional image based on slice thickness of 0.75mm, 1.5mm, 3.0mm and 5.0mm respective-ly. Meanwhile, we observed the pulmonary lobar, segmental, subsegmental vessels and recorded if there was pulmo-nary embolus. Results:28 patients were all diagnosed as pulmonary embolism. The display rates of the main pulmo-nary artery in the four different thickness groups were all 100%. In the four thicknesses groups, the display rate of lo-bar artery was no obvious differences(P>0.05), of segmental, subsegmental, grade 5 and grade 6 arteries were obvi-ous difference(P<0.05). The number of embolism vessels in the left lower lobe was significantly higher than that of the right upper lobe, right middle lobe and right lower lobe,and left upper lobe. The four different thicknesses groups show different average pulmonary artery embolus displaying rates. There was no obvious difference between 0.75mm and 1.5mm thicknesses group(P>0.05), they both were obviously better than that of 3.0mm and 5.0mm thicknesses group. Conclusion:The 64-slice spiral pulmonary artery angiography of 1.5mm thickness reconstruction can effec-tively improve the pulmonary artery and pulmonary embolus displaying rate, which will improve the diagnosis effi-ciency and accuracy of pulmonary embolism, so it has an important clinical diagnosis value.