螺旋CT肺动脉造影对肺血栓栓塞症的诊断价值

VALUE OF SPIRAL COMPUTED TOMOGRAPHY PULMONARY ANGIOGRAPHY IN THE DIAGNOSIS OF THROMBOEMBOLISM

①目的 探讨螺旋CT肺动脉造影 (SCTPA)在肺血栓栓塞症 (PTE)诊断中的应用价值。②方法对 2 6例PTE病人从足侧向头侧扫描 ,同时行下腔静脉系造影 (CTV)。③结果 2 6例病人 4 81支肺动脉中 116支发生了栓塞 (2 4 % ) ,其直接征象为腔内充盈缺损 93支 (80 % ) ,完全阻塞 2 3支 (2 0 % ) ;间接征象为“马赛克”征 9例 ,肺梗死 1例 ,肺动脉高压 9例 ,胸腔积液 6例。在同时进行的CTV中 ,2 4例显示静脉栓子 ,单侧 16例 ,双侧 8例。④结论 SCTPA是诊断PTE准确、简便、无创伤的有效方法 。

Objective To evaluate the value and technique of spiral computed tomography pulmonary angiography (SCTPA) in the diagnosis of pulmonary thromboembolism(PTE). Methods Twenty-six patients with PTE were examined in caudocranial direction followed by computed tomography venography (CTV) in pelvic and lower limbs were performed. Results An embolism was found in 116 of 481 pulmonary arteries in 26 cases (24%). Direct manifestations of PE included intravascular filling defect (n=93, 80%), complete obstruction (n=23, 20%). Indirect signs were 'mosaic' sign (n=9), pulmonary infarction ( n=1), pulmonary artery hypertension (n=9), pleural effusion (n=6).Venous emboli were demonstrated in 24 cases, of which 16 cases were unilateral, eight were bilateral. Conclusion SCTPA is an effective method for the diagnosis of PTE, which is accurate, easy to perform and noninvasive. Moreover, additional contrast agent was unnecessary in the following CTV.