螺旋CT增强扫描在诊断和治疗肺动脉栓塞中的应用

目的 评价螺旋CT在诊断和治疗肺动脉栓塞（肺栓塞）中的作用。方法 对16例（年龄35－74岁）行螺旋CT检查的肺栓塞病人进行回顾性分析。使用PQ6000型单层螺旋CT机，连续容积增强扫描。结果 共计分析176支肺动脉分支，受累89支，占50．2％；双侧下叶主支受累最多（达31．5％）；累及左、右肺动脉主干者为16％，累及肺叶以下分支达84％，未见累及主肺动脉的病例。肺动脉栓塞螺旋CT增强扫描的直接征象为肺动脉腔内偏心性、类圆形充盈缺损，附壁性类环形充盈缺损，管腔闭塞，血栓位于管腔中央的“轨道症”；并存的间接征象包括主肺动脉增宽、局限性肺纹理稀疏、肺梗死和胸腔积液。结论 在肺动脉栓塞的诊断,螺旋CT增强扫描是一种有效的无创性检查手段，且安全、快速。在肺栓塞的定性定量诊断和指导选择治疗方法上，可以起到重要作用。

Clinical application of spiral CT angiography in diagnosis of pulmonary embolism

Objective: To evaluate of spiral CT in the noninvasive diagnosis of pulmonary embolism (PE).Methods: 16 patients aged from 35 74 years (male 12, female 4 ) had PE demonstrated by spiral CT. Continous volume scan was used with PQ 6000 scanner. Results: Among 176 pulmonary artery branches in 16 cases, 89 branches were involved with PE (50 2%). Left and right main pulmonary artery in 15 7%, lobar artery and segmental artery in 84%. The direct signs of spiral CT are: partial filling defect (60%), mural filling defect (18%), total occlusion (14 6%) and railway track sign (7 9%). Enlargement of pulmonary artery trunk, local pulmonary oligemia, pulmonary infarction and pleural effusion are the secondary sings.Conclusion: Spiral CT is a noninvasive and effective method for diagnosing PE. It could play an important role in clinical diagnosis of PE.