16层螺旋CT肺血管造影在肺动脉栓塞诊断中的应用

目的　研究 16层螺旋CT肺血管造影在肺动脉栓塞诊断中的应用价值。方法　使用 16层螺旋CT扫描机 (SiemensSensation 16 )对临床拟诊肺栓塞的 4 9例患者进行前瞻性研究。采用层厚 3mm行胸部增强扫描。利用原始数据行层厚 1mm的轴面及多平面重建 (MPR)。比较层厚 3mm、1mm的轴面图像及MPR图像。结果　CT诊断肺栓塞 4 2例。病变共累及肺动脉 35 2支。对于主肺动脉及肺叶动脉栓塞 ,三种图像检出结果一致。但对于肺段及亚段动脉栓塞 ,层厚 1mm较 3mm显示率高 ,差异有显著意义 (P <0 0 1) ,1mm的MPR较轴面图像显示率高 ,但差异无显著性意义 (P >0 0 5 )。结论　 16层螺旋CT肺血管造影无创、快速、敏感性高 ,应当作为肺栓塞的首选检查方法。

The role of 16-detector row spiral CT pulmonary angiography in the diagnosis of pulmonary embolism

Objective To study the role of pulmonary angiography with 16-detector row spiral CT in the diagnosis of pulmonary embolism (PE).Methods Forty-nine patients suspected of having pulmonary embolism were examined prospectively with 16-detector row spiral CT pulmonary angiography.Contrast enhanced 3-mm section thickness was used to scan the entire chest and the raw data were used to perform the reconstruction with 1-mm section thickness and multiplanar reformation (MPR).The axial images of 3-mm,1-mm section thickness,and MPR were compared.Results PE were diagnosed in 42 of 49 patients,and 352 branches were detected,including 8 left or right main pulmonary arteries,96 lobar arteries,132 segmental vessels,and 116 subsegmental arteries.For displaying the emboli in main pulmonary arteries and lobar arteries,the results of the images with 3-mm,1-mm section thicknesses and MPR were identical.But 1-mm-thick section yielded higher rate of detecting emboli in segmental and subsegmental pulmonary arteries compared with 3-mm-thick sections,and there was significant difference statistically (P<0.01),and 1-mm-thick section MPR achieved a better result in revealing the abnormalities in comparison to the axial images,but there was no significant difference statistically (P>0.05).Conclusion 16-detector row spiral CT pulmonary angiography is non-invasive,fast,and highly sensitive for PE,and it should be the modality of choice for the diagnosis of PE.