CT、MRI诊断肺动脉栓塞患者栓子分布特征及准确性探讨

目的探讨CT与MRI在肺栓塞诊断中的价值及肺栓塞的影像表现。方法选择我院收治的肺动脉栓塞患者50例,全部患者均行CT及MRI动脉造影检查,比较两种方法的诊断价值。结果 CT肺动脉造影显示肺动脉血栓48例（96.0%）,主要表现为肺动脉充盈缺损,远端血管不显影,检出各级动脉及分支血管栓子78处;MRI动脉血管造影显示肺动脉血栓41例（82.0%）,主要显示肺动脉腔内充盈缺损,远端信号消失,检出各级动脉血管及分支栓子共64处;DSA检查确诊50例患者均为肺栓塞,各级血管栓子80处。以DSA为标准,CT与MRI肺动脉栓塞诊断率比较,差异有统计学意义（P〈0.05）,栓子检出率比较,差异有统计学意义（P〈0.05）。结论 CT血管造影检查肺栓塞的准确性及栓子的检出率均优于MRI,可作为首要的无创检查手段

Study of distribution feature and accuracy in pulmonary embolism diagnosising by CT and MRI

Objective To evaluate the diagnosis value of Spiral CT and MRI imaging in pulmonary embolism and CT and MRI performance.Methods Clinical data of 50 patients of pulmonary embolism diagnosed by DSA in our hospital were analyzed retrospectively,all patients were given spiral CT and MRI angiography examination,the diagnosis value of two imaging methods were compared.Results Spiral CT pulmonary angiography showed pulmonary artery thrombosis in 48 patients(96.0%),the main performance was pulmonary artery filling defect,distal non-imaging,78 embolus were detected in Arterial blood vessels and its branches;MRI angiogram showed pulmonary artery thrombosis in 41 patients(82%),with the main pulmonary artery filling defect,the remote signal disappeared,and 64 embolus were detected;50 patients of pulmonary embolism were diagnosed by DSA with 80 embolus in Arterial blood vessels and its branches.In standard of DSA,the difference of diagnosis rate of pulmonary embolism between CT and MRI was statistically significant(P < 0.05),the difference of embolus detection rate was statistically significant(P < 0.05).Conclusion The detection accuracy rate of Spiral CT angiography of pulmonary embolism and embolus are better than MRI imaging,it can be used as the first noninvasive detection method.