MSCT肺动脉成像在肺动脉栓塞诊断中的应用价值

The value of MSCT pulmonary artery angiography in the diagnosis of pulmonary embolism

目的探讨多层螺旋CT(MSCT)肺动脉造影在肺动脉栓塞(PE)诊断中的应用价值。方法选取2016年2月至2017年9月在我院治疗的肺动脉栓塞患者62例,均经数字减影血管造影(DSA)检查确诊,所有均采用MSCT和MRI检查,比较两种方法的诊断情况。结果 62例患者经DSA检查确诊共有血管栓子97个,主要分布于肺主动脉、左肺动脉干和右肺动脉干,分别占25.77%、15.46%和18.56%;MSCT检查PE诊断率和栓子诊断率分别为93.55%和94.85%,明显高于MRI检查,差异比较有统计学意义(P<0.05);MSCT和MRI检出马赛克征、心包积液或胸腔积液、肺段梗死和局限性肺纹理稀疏等PE间接征象比例差异比较无统计学意义(P>0.05);62例患者中MSCT肺动脉栓塞指数为(32.18±5.44),RVd为(4.45±0.84)cm,LVd(4.13±0.75)cm,RVd/LVd为(1.32±0.43),肺动脉栓塞指数与RVd和RVd/LVd呈正相关(r=0.873和0.886,P<0.05),与LVd呈负相关(r=-0.845,P<0.05)。结论 MSCT肺动脉成像在肺动脉栓塞诊断中具有较好的应用价值,其肺动脉栓塞指数与右心功能参数有一定关系。

Objective To investigate value of multi-slice spiral CT(MSCT)pulmonary arteriography in the diagnosis of pulmonary embolism(PE).Methods From February 2016 to September 2017,62 cases of pulmonary embolism treated in our hospital were diagnosed by digital subtraction angiography(DSA),all of them were examined by MSCT and MRI,the diagnosis of two methods was compared.Results 97 vascular emboli of 62 patients were diagnosed by DSA,mainly distributed in pulmonary artery,left pulmonary artery and right pulmonary artery,accounting for 25.77%,15.46%and 18.56%respectively;The diagnostic rate of PE and the diagnostic rate of emboli in MSCT were 93.55%and 94.85%,which were significantly higher than that of MRI,and the difference was statistically significant(P<0.05);There was no significant difference in mosaic sign,pericardial effusion or pleural effusion,segmental infarction and localized pulmonary texture thinning of PE indirect signs between MSCT and MRI(P>0.05);MSCT pulmonary embolism index in 62 cases patients were(32.18±5.44),RVd were(4.45±0.84)cm,LVd were(4.13±0.75)cm,RVd/LVd were(1.32±0.43),pulmonary artery embolism index were positively correlated with RVd and RVd/LVd(r=0.873 and 0.886,P<0.05),was negatively correlated with LVd(r=-0.845,P<0.05).Conclusion MSCT pulmonary artery angiography has good value in the diagnosis of pulmonary embolism,the index of pulmonary artery embolism is related to the parameters of right heart function.