肺动脉栓塞的螺旋CT增强表现的探讨

目的 探讨肺栓塞螺旋CT增强扫描的影像表现，提高肺栓塞的诊断水平。方法 对14例肺栓塞患者行螺旋CT增强扫描，观察血栓累及部位及影像学表现。结果 14例患者共累及51处肺动脉及其分支，其中右肺动脉主干栓塞5例，左肺动脉弓3例，右上肺动脉6例，右中肺动脉4例，右下肺动脉13，左上肺动脉8例，左下肺动脉12例。肺栓塞的CT表现：①直接征象：肺动脉内充盈缺损，表现为中心型充盈缺损、锐角附壁型血栓、钝角附壁型血栓、完全阻塞型充盈缺损4种形式；②间接征象：肺动脉栓塞的间接征象有受累部分肺野透亮度增高、肺纹理细小稀疏、“马赛克”征、肺实变、主肺动脉增宽、右心室增大、胸腔积液、心包积液等。结论 螺旋CT增强扫描是诊断肺动脉栓塞的一种无创、快速的影像检查方法。

Image features of pulmonary embolism by contrast-enhanced spiral CT

Objective To study the image features of pulmonary embolism (PE) by contrast-enhanced spiral CT. Methods 14 cases of pulmonary embolism were examined by contrast-enhanced CT and analyzed retrospectively. Results There were 51 pulmonary artery and artery branches involved in 14 cases of pulmonary embolism. Of them, there were 5 embolism in right main pulmonary arteries,3 in left pulmonary artery arches,6 in right superior pulmonary arteries, 4 in right middle pulmonary arteries, 13 in right inferior pulmonary arteries, 8 in left superior pulmonary arteries and 12 left inferior pulmonary arteries.The direct CT manifestations of pulmonary embolism were various types of intraluminal filling defects Secondary CT signs included higher diaphaneity of lung, reduced pulmonary vascular markings, "mosaic" sign, consolidation of the lung, dilatation of the pulmonary artery, enlargement of the right ventricle, pleural effusion and pericardial effusion. Conclusion Contrast-enhanced spiral CT is a non-invasive, fast diagnosis method for pulmonary embolism.