多层螺旋CT肺动脉造影诊断肺栓塞及鉴别诊断

目的探讨多层螺旋CT肺动脉造影（MSCTPA）诊断肺栓塞及鉴别诊断。方法对36例MSCTPA检查的肺栓塞患者分别行1．25mm层厚横断面及MPR重建，由两位有经验的影像科医师记录显示清楚的叶、段、亚段及第5级肺动脉内有无栓子。结果右肺动脉干单发栓子1例，肺动脉干、叶、段多发栓子9例，肺动脉干、叶、段、亚段多发栓子4例，叶、段肺动脉多发栓子11例，叶、段、亚段肺动脉多发栓予4例，仅肺段动脉多发栓子2例，段、亚段肺动脉多发栓子3例，段、亚段、5级肺动脉多发栓子1例，仅亚段肺动脉多发栓子1例。结论16层螺旋CT明显地提高了肺小血管和血管内栓子的显示率，特别是对下肺动脉较粗亚段及第5级肺动脉栓子的显示更确切，但在诊断中应注意与原发性肺动脉肿瘤等其他疾病相鉴别。

Diagnosis and differential diagnosis of pulmonary embolism with multislice computed tomographic pulmonary angiography

Objective To investigate the diagnosis and differential diagnosis of pulmonary embolism with multislice computed tomographic pulmonary angiography. Methods The CT scan images with slice thickness of 1.25 mm and MPR were reconstructed in 36 patients with puhnonary embolism after contrast enhanced multislice spiral CT angiograms. Two thoracic radiologists independently reviewed examination findings to determine if each lobar, segmental, subsegmental, fifth artery was well - visualized for presence of pulmonary embolism. Results One patient visualized single pulmonary thromboemboli in right pulmonary artery trunk, 9 cases in pulmonary artery trunk and lobar and segment arteries, 4 cases in pulmonary artery trunk and lobar and segment and subsegment arteries, 11 cases in lobar and segment arteries, 4 cases in lobar and segment and subsegment arteries, 2 cases in segment arteries, 3 cases in segment and subsegment arteries, 1 cases in segment and subsegment and fifth pulmonary arteries, 1 cases in subsegment arteries respectively. Conclusions The 16 - multisliee CT significantly improves visualization of pulmonary thromboemboli at segmental and subsegmental arteries and bilateral inferior fifth arteries. But the differential diagnosis of pulmonary embolism should be considered.