多层螺旋CT对肺动脉栓塞的诊断价值

目的探讨肺动脉栓塞(pu lmonary embolism,PE)的多层螺旋CT(MSCT)表现特征,评价MSCT对PE的诊断价值。方法回顾分析43例临床诊断PE患者的16层螺旋CT肺动脉造影资料的影像学表现,并与其肺动脉造影(DSPA)或随访结果相对照。结果本组43例均与临床诊断相符,中心型16例,周围型23例,混合型4例。多层螺旋CT肺动脉造影(MSCTPA)对叶及叶以上肺动脉的显示率达100%,检出PE阳性20支,段肺动脉清楚显示726支(显示率达84.4%),检出PE阳性109支,亚段肺动脉清楚显示1185支(显示率达68.9%),检出PE阳性61支。PE的直接征象包括血管腔完全闭塞、部分充盈缺损、轨道征和附壁血栓;间接征象有肺梗死灶、“马赛克”征、右室增大和/或肺动脉扩张、胸腔积液、心包积液等。结论MSCTPA诊断PE简便、安全、无创,对亚段肺动脉栓塞的诊断准确、可靠,是诊断早期肺动脉栓塞的首选方法。

Diagnostic Value of Multislice Spiral CT in Pulmonary Artery Embolism

Objective To research the manifestations of MSCT of pulmonary artery embolism(PE),and to evaluate the value of multislice spiral CT in pulmonary artery embolism.Methods 43 cases of pulmonary artery embolism were analyzed;all the case underwent MSCT with acquisition of 16-slice for one scan.The results were compared with the DSPA and follow-up MSCTPA.Results All the central pulmonary artery embolism,the displaying rate was 100% by 16-slice spiral CT.The indirect signs included dilated central and/or right interloper arteries,pleural effusion,westermark's sign,and pulmonary infarction,enlargement of right ventricle with or without displacement of interventricular septum,mosaic sign and the dilatation of bronchial arteries.Conclusion 16-slice spiral CT is a fast,effective,and non-invasive diagnostic method for PE;it will be the gold standard in diagnosis of pulmonary artery embolism.