40层螺旋CT在肺动脉栓塞诊断中的应用价值

目的:探讨40层螺旋CT在肺动脉栓塞中的应用价值.方法:使用40层螺旋CT扫描机(Siemens Defination AS 40)对临床初步诊断肺动脉栓塞的38例患者进行研究.采用层厚5 mm行胸部增强扫描.利用3D后处理工作站进行重建为0.75 mm的轴面及多平面重建(MPR).比较层厚5 mm和1mm的轴面图像及MPR图像.结果:CT诊断肺动脉栓塞31例.病变共累计肺动脉260支.对于主肺动脉及肺叶动脉栓塞,3种图像检出结果一致.但对于肺段及亚段肺动脉栓塞的显示,层厚0.75 mm优于5 mm,差异有显著性意义(P<0.01),0.75 mm的MPR与轴面图像间差异无显著性意义(P＞0.05).结论:40层螺旋CT在肺动脉栓塞诊断中具有无创、快速、敏感性高的优点,应当作为肺动脉栓塞的首选检查方法.

The Role of 40-detector Row Spiral CT in the Diagnosis of Pulmonary Embolism

Objective：To study the role of pulmonary angiography with 40-detector row spiral CT in the diagnosis of pulmonary embolism（PE）.Methods：Thirty-two patients suspected of having pulmonary embolism were examined prospectively with 40-detector row spiral CT pulmonary angiography.Contrast enhanced 5 mm section thickness was used to scan the entire chest and the raw data were used to perform the reconstruction with 0.75 mm section thickness and multiplanar reformation（MPR）.The axial images of 5 mm,0.75 mm section thickness,and MPR were compared.Results：PE were diagnosed in 26 of 32 patients,and 215 branches were detected.For displaying the emboli in main pulmonary arteries and lobar arteries,the results of the images with 5 mm,0.75 mm section thickness and MPR were identical.But 0.75 mm section yielded higher rate of detecting emboli in segmental and subsegmental pulmonary arteries compared with 5 mm thick sections,and there was significant difference statistically（P0.01）,and 0.75 mm thick section MPR achieved a better result in revealing the abnormalities in comparison to the axial images,but there was no significant difference statistically（P0.05）.Conclusions：40-detector row spiral CT pulmonary angiography is non-invasive.fast,and highly sensitive for PE,and it should be the modality of choice for the diagnosis of PE.