64层螺旋CT对肺动脉血栓栓塞症诊断价值的探讨

【目的】探讨64层螺旋CT（SCT）扫描对肺动脉血栓栓塞症（PTE）的诊断价值。【方法】选择22例PTE患者的64层SCT肺动脉成像资料，分析PTE栓子的形态特征和PTE间接征象。【结果122例中，血栓全部表现肺动脉内充盈缺损，共126个栓子，其中栓子位于主肺动脉为2个，左右肺动脉干内13个，肺叶动脉49个，肺段及以下62个；除外主肺动脉的2个栓子，右侧77个，左侧47个，其中表现为中心型充盈缺损25个、附壁型充盈缺损79个、完全闭塞型分别为22个。PTE间接征象：“肺少血”征2例、“马赛克”征3例，肺大片实变3例，肺梗塞10例，肺动脉扩张4例，胸腔积液12例。【结论]64层螺旋CT血管成像诊断PTE简便、安全、准确性高，是PTE一种重要而可靠的临床诊断方法。

Value of 64-slice Spiral CT Pulmonary Angiography in Diagnosing Pulmonary Thromboembolism

Objective]To explore the value of 64-slice spiral CT in the diagnosis of pulmonary＇thromboernbolism （PTE）. Methods] The image data of 64-slice spiral CT pulmonary angiography of 22 PTE patients were selected. The morphological features of emboli and indirect signs of PTE were analyzed. Results] A- mong the 22 cases, all performances of the pulmonary were artery thrombus filling defects in 126 emboli in which 2 emboli located in the main pulmonary trunks, 13 emboli in left and right pulmonary trunks, 49 emboli in pulmonary lobes and 62 emboli in pulmonary segments and below. Among 2 emboli in the main pulmonary artery, 77 emboli in the right pulmonary artery and 47 in the left pulmonary artery, the central filling defect was found in 25 emboli, mural-based filling defect in 79 emboli and complete occlusion in 22 emboli. Indirect signs of PTE included pulmonary oligaemia sign in 2 cases, mosaig sign in 3 cases, large pulmonary consolidation in 3 cases, pulmonary infarction in 10 cases, pulmonary expansion in 4 cases and pleural effusion in 12 cases. Conclusion] The 64-slice spiral CT angiography for the diagnosis of PTE is simple, safe and accurate, so it is an important and reliable means for diagnosing PTE.