急性血栓性肺栓塞影像学诊断

目的探讨影像学检查对急性血栓性肺栓塞的诊断价值。方法男性7例，女性2例，年龄30—68岁，每位患者分别行胸部X线、螺旋CT肺血管造影、肺动脉DSA检查，确诊为肺动脉干或分支的栓塞，在行DSA检查之后同时行肺动脉小剂量溶栓药物灌注治疗。结果急性肺栓塞患者9例，胸平片共有22种阳性征象占全部胸部征象36种61．1％（22／36），SCTA显示有26支肺动脉血管受累；DSA检查均不同程度显示有肺动脉血流减少或消失、肺动脉充盈缺损、分支狭窄或阻塞。结论胸部X线平片可作为肺栓塞首选诊断方法，螺旋CT肺血管造影是诊断肺动脉较大分支较可靠的方法；肺动脉DSA是肺动脉栓塞最清晰准确的诊断方法。同时藉介入导管灌注溶栓药物也是治疗急性肺栓塞的有效方法。

Radiographic Diagnosis of Acute Pulmonary Embolism

Objective To investigate the value of radiographic examination in diagnosis of acute pulmonary thromb-embelism. Methods There were 7 male and 2 female aged from 30 - 68 years. Pulmonary atery trunk or branch embolism were diagnosed toward each patient by chest radiography, pulmonary atery CT angiagraphy and pulmonary atery DSA. Pulmonary atery perfusiom with little-dose thrombolytic medicine was performed after the examination of pulmonary DSA. Result 22 kinds of positive obvious signs and symptoms which percentage of all 36 kinds of chest signs and symptoms was 61.1% were found in all 9 patients by procedure of radiography. It showed 26 pulmonary atery branches were affected; it showed different characters such as reduction or disappearance of pulmorary atery blood flow, pulmonary filling defect, stenosis or embolism of pulmorary branch. Conclusion Chest radiography may be the first selected method, pulmonary atery spiral CT angiography is the reliable method in diagnosis of thicker pulmonary branch embolism and pulmonary atery DSA is a hopeful method in diagnosis of pulmonary atery embolism,at the same time,perfusion of thrombolytic medicine in pulmonary atery is effective method in treatment of accute pulmonary thrombo-embolism.