16层螺旋CT血管造影在肺动脉栓塞诊断中的应用

目的评价16层螺旋CT血管造影(MSCTA)在诊断肺动脉栓塞(PE)中的价值。方法10例临床怀疑PE患者行16层螺旋CT平扫及肺动脉造影检查,并行轴面、多平面重建(MPR)和最大密度投影(MIP)、容积再现(VII)。结果10例患者经MSCTA检查后8例确诊为PE,8例PE患者中发现34支肺段以上肺动脉发生PE,CT直接征象:充盈缺损(中心性和偏心性)、附壁血栓及完全性阻塞;间接征象:"马赛克"征、胸膜下梗死灶、肺动脉高压、胸腔积液、心包积液;其中MPR和MIP对栓子显示满意。结论多层螺旋CT血管造影是诊断肺PE的一种无创伤的有效检查方法,可代替肺动脉造影,可能成为诊断PE的首选。

Clinical application of 16-detector multislice spiral CT angiography in diagnosis of pulmonary embolism

Objective To evaluate the significance of mutiple spiral CT angiography(MSCTA)in diagnosis of pulmonary embolism(PE).Methods 10 patients who were clinically suspected as pulmonary embolism were exa mined by 16-detector multislice spiral CT,pulmonary artery angiography,MPR,MIP and VR.Results Among 10 pa- tients,8 cases were diagnosed as PE by MSCTA.Among the 8 cases,34 vessels were involved with embolism.Direct signs of PE included filling defect,embolism attached to the wall of host artery,and total occlusion of the pumlonary arteries.Indirect signs included mosaic sign,subpleutral infarction,pulmonary hypertension,pleural effusion and peri- cardium effusion.Conclusion MSCTA is a non-invasive and effective diagnostic method,which may replace the pul- monary angiography and become the first choice in the diagnosis of PE.