肺动脉栓塞的CT血管造影检查

目的研究CT肺动脉血管造影联合下肢深静脉血管造影在肺栓塞的诊断中的作用及多层螺旋CT的优势。方法采用单层螺旋CT或16层螺旋CT对临床拟诊肺栓塞的所有患者行肺动脉血管造影(CTPA)及下肢静脉血管造影,统计栓塞的数目及类型。结果44例肺栓塞中,肺栓塞合并下肢静脉栓塞的34例,单纯肺栓塞的10例。单层螺旋CT及16层螺旋CT检查的病人总的栓塞显示率分别为12.1%及19.0%,差异有统计学意义(P=0.004);肺段及肺段以上肺动脉栓塞的显示率分别为25.3%及29.7%,差异无统计学意义(P=0.104);亚段及亚段以下显示率分别为1.1%及10.2%,差异有统计学意义(P=0.000)。结论CT肺动脉血管造影联合下肢血管造影是肺栓塞的无创、快速、敏感性和特异性均较高的诊断方法。16层螺旋CT在检查肺栓塞方面优于单层螺旋CT。

CT Angiography of Pulmonary Embolism

Objective To study the value and the superiority of multi-slice spiral CT angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing pulmonary embolism (PE). Methods CT pulmonary angiography (CTPA) and lower limb deep vein venography were performed in all suspected patients of PE with single or multi-slice spiral CT.The number and type of the embolus were calculated.Results Among the 44 patents of pulmonary embolism,34 patents had both PE and deep vein thrombo embolism (DVT) ,10 patients had only PE.The total ratio of the PE diagnosed with single slice spiral CT and multi-slice spiral CT was 12.1% and 19.0%, respectively , there were statistical significance, (P=0.004); the ratio of the PE upon deuto-segment pulmonary arteries was 25.3% and 29.7%, respectively, there was no statistical significance, (P=0.104); the ratio of the PE below deuto-segment pulmonary arteries was 1.1% and 10.2%, respectively, there was statistical significance, (P=0.000).Conclusion The technique of angiography of pulmonary artery in combination with deep vein of lower limb in diagnosing PE is a non-invasive, fast, sensitive and specific method for PE. Multi-slice spiral CT is superior to single slice spiral CT in the diagnosis of PE.