64排VCT增强扫描在肺动脉栓塞中的诊断价值

目的:探讨64排容积CT(VCT)增强扫描在肺动脉栓塞诊断中的价值.方法:搜集17例经64排VCT增强扫描确诊的肺动脉栓塞患者的影像资料,所有病例均行多平面重组(MPR)、曲面重组(CPR)、三维容积成像(VRT)及最大密度投影(MIP)等后处理,对血栓的形态、部位、表现形式以及其它相关改变进行归类分析.结果:17例共累及肺动脉及其分支87处,其CT表现直接征象:中心性充盈缺损(轨道征)9处、偏心性或附壁性充盈缺损26处、完全阻塞性充盈缺损(血管截断征)13处;间接征象:肺动脉增宽7例、局限性肺纹理稀疏和肺灌注不均(马塞克征)14例、肺梗死6例、胸腔积液6例、心包积液4例.结论:64排VCT增强扫描是一种安全、快捷、有效的诊断肺栓塞的无创性检查手段,其检出率高,可作为肺栓塞的首选检查方法.

64-detector volume CT angiography in diagnosis of pulmonary embolism

Objective：To investigate the diagnostic value of 64-slice volume CT angiography （VCTA） in the diagnosis of pulmonary embolism （PE）. Methods： 64-slice VCTA was performed in 17 patients with PE. The images of multiplanar reformation （MPR）, curved planar reformation （CPR）, maximum intensity projection （MIP）, volume rendering （VR） were obtained on a postprocessing workstation. Location, thickness and morphological characteristics of thrombi were deter- mined. Results：Of the 17 patients with PE,87 pulmonary arterial branches were involved. Direct VCT sign of PE included track sign （n= 9）,mural thrombus （n= 26）, and complete occlusions of the arteries （n= 13）. Indirect sign of PE included poststenotic dilatation （n= 7）, tortuous vessels, enlargement of the main pulmonary artery, enlargement of the bronchial ar- teries, nonuniform arterial perfusion （n= 14）, pulmonary infarction （n= 6）, pleural effusion （n= 6） and pericardial effusion （n= 4）. Conclusion：VCTA is a safe, effective and non-invasive imaging technique that allows the comprehensive evaluation of PE in terms of morphologic features,making it the first-line imaging modality for the evaluation of PE.