多层螺旋CT在肺动脉栓塞诊断中的应用(附27例报告)

目的:探讨多层螺旋CT肺动脉成像(CTPA)对肺动脉栓塞的诊断价值.方法:对27例经MSCT确诊肺动脉栓塞患者进行回顾性分析.结果:多发肺动脉栓塞18例,其中双侧多发15例,左侧多发1例,右侧多发2例;单发9例,其中肺动脉干4例,叶动脉1例,段动脉4例.肺动脉栓塞的直接征象包括肺动脉主干或其分支的充盈缺损及肺动脉段面细小及管腔内不均匀密度减低;间接征象可以有肺内"马赛克征"、楔形影或索条状影,胸腔积液或胸膜肥厚.结论:CTPA对肺动脉栓塞的检查是一种价格便宜,无创伤的检查,诊断结果可靠,可作为急诊和普通临床工作中怀疑本病时首选的影像学检查方法.

Clinicai Application of Multi-slice Computed Tomography in the Diagnosis of Pulmonary Embolism

Objective:To investigate the value of multi-slice computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism.Methods:27 cases of pulmonary embolism diagnosed with CTPA were retrospectively analyzed.Results:18 cases were diagnosed as multiple pulmonary embolism,among them,15 cases were bilaterally involved,PA located only at the left side (n=1),and at the right side (n=2).9 cases were diagnosed as solitary pulmonary embolism,among them the locations were within the pulmonary trunk (n=4),within the lobular arterial branch (n=1),and within the segmental branch (n=4).Direct signs of pulmonary embolism included filling defect within pulmonary trunk or its braches;diminution of the pulmonary artery lumen at its cross section images,and heterogeneous decrease of attenuation within the lumen.Indirect signs included "mosaic sign",wedge or linear-shaped opacities in lung,pulmonary effusion or plural thickening.Conclusion:MSCT pulmonary angiography is an inexpensive,non-invasive and reliable technique in the diagnosis of pulmonary embolism,which can be used as the primary imaging modality both in emergency and in routine clinical practice for patients suspected of having pulmonary embolism.