16层螺旋CT肺动脉造影诊断肺栓塞的价值

目的探讨16层螺旋CT肺动脉造影在肺栓塞（PE）诊断中的应用价值。方法对2012年3月至2013年4月经我院初步诊断为PE的患者43例行多层螺旋CT肺动脉造影（MscTPA）检查，将所获原始图片传输至工作站进行图片后处理，重建的方法分别为容积再现（VR）、多平面重建（MPR）和最大密度投影（MIP）。结果29例患者发现PE，病灶部位位于两侧21例，位于右侧5例，位于左侧3例。病变共累及324支肺动脉，其中肺动脉干7支，左、右肺动脉26支，叶动脉68支，段动脉178支，亚段动脉45支。直接征象为充盈缺损和血管截断征，间接征象为肺梗死、胸腔积液、肺动脉高压等。结论MSCTPA在PE的诊断中能清楚地显示PE的特点和受累部位，具有无创、安全和方便的特点，建议在临床上进一步推广应用。

Application value of multi-slice CT pulmonary angiography in the diagnosis of pulmonary embolism.

Objective To explore the application value of multi-slice CT pulmonary angiography （MSCT- PA） in the diagnosis of pulmonary embolism （PE）. Methods Forty-three patients who were initially diagnosed as PE in our hospital from March 2012 to April 2013 were examined by MSCTPA. The original picture were transferred to a workstation for image post-processing, reconstruction methods used were volume rendering （VR）, multiplanar reconstruction （MPR） and maximum intensity projection （MIP）. Results A total of 29 patients were diagnosed as PE, of which 21 cases located on both sides, 5 cases located on the right side, 3 cases located the left side. A total of 324 pulmonary lesions were involved, including 7 in pulmonary trunk, 26 in left or right pulmonary artery, 68 in lobar artery, 178 in segmental artery, and 45 in sub segmental artery. Direct signs found were filling defects and vascular truncation sign, and indirect signs included pulmonary infarction, pleural effusion, and pulmonary hypertension. Conclusion Diagnosis of PE by MSCTPA can clearly show the characteristics and the affected area of PE, with features of non-invasive, safe and convenient, thus should be further promoted clinically.