螺旋CT肺动脉造影对肺栓塞的诊断

目的：评价螺旋CT及其肺动脉造影诊断肺动脉栓塞（PE）的价值。方法：回顾性分析12例PE患,均行螺旋CT容积扫描,并在工作站进行图像后处理,获得肺动脉多平面重建图像及三维立体图像。结果：对12例196支肺动脉分支进行分析,受累率为46.4%;栓子发生在主肺动脉、左右肺动脉干及叶段肺动脉。多平面重建图像上表现为充盈对比剂血管内有充盈缺损区,或其远侧方无对比剂充填区。肺动脉成像示,主干血管内可见充盈缺损影,或呈截断状影;叶栓塞或段栓塞亦呈突然“截断状”,其远侧方肺动脉分支不显影或呈纤维状。结论：螺旋CT肺动脉造影不仅可以获得轴位图像,而且可以获得立体图像,可多轴向旋转观察PE部位,是诊断叶或段以上PE可靠而直观的检查方法。

Spiral CT pulmonary angiography in the diagnosis of pulmonary emobolism

Objective:To discuss the diagnostic value of spiral CT pulmonary angiography in the diagnosis of pulmonary embolism(PE).Methods:12 patients with PE were performed spiral CT volume scanning.Three dimensional and multiplanar images of pulmonary artery were obtained after post procession in the work station.Results:Among 196 branches of pulmonary arteries in 12 patients,PE was found in 46.4%.Embolism located in main pulmonary artery,left or right pulmonary artery,lobar arteries and segmental arteries.On multiplanar images,it showed intraluminal filling defect or no contrast medium in distant pulmonary arteries.On the pulmonary angiography images,it showed filling defect or cutting off sign in main pulmonary arteries;similar changes were observed in the lobar or segmental branches.Conclusion:SCTA images could obtain more diagnostic imformation by observing PE from different directions.SCTA is a reliable method in diagnosis of PE above the level of lobar or segmental artery.