螺旋CT与MRI血管造影在肺动脉栓塞诊断中的价值比较

目的探讨螺旋CT与MRI在肺栓塞诊断中的价值及肺栓塞的CT及MRI表现。方法回顾性分析本院2005年10月～2010年12月收治并经临床确诊为肺栓塞的患者40例的资料．全部患者均行螺旋CT及MRI动脉造影检查，均经DSA诊断确诊，分析比较两种影像方法的诊断价值。结果螺旋CT肺动脉造影显示肺动脉血栓39例（97．5％），主要的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69处；MRI动脉血管造影显示肺动脉血栓35例（87．5％），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58处；DSA检查确诊40例患者均为肺栓塞，各级血管栓子72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）。结论螺旋CT血管造影检查肺栓塞的准确性及栓子的检出率均优于核磁检查，可作为DSA检查之前首要的无创检查手段。

The diagnosis value of Spiral CT and MRI imaging in pulmonary embolism

Objective To evaluate the diagnosis value of Spiral CT and MRI imaging in pulmonary embolism and CT and MRI performance.Methods Clinical data of 40 patients of pulmonary embolism diagnosed by DSA in our hospital from October 2005 to December 2010 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 39 patients(97.5%),the main performance was pulmonary artery filling defect,distal non-imaging,69 embolus were detected in arterial blood vessels and its branches;MRI angiogram showed pulmonary artery thrombosis in 35 patients(87.5%),with the main pulmonary artery filling defect,the remote signal disappeared,and 58 embolus were detected;40 patients of pulmonary embolism were diagnosed by DSA with 72 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,and it can be used as the first noninvasive detection method before DSA.