16层螺旋CT增强扫描诊断肺动脉栓塞-42例征象分析

目的探讨16层螺旋CT增强扫描肺动脉栓塞的临床应用价值。方法回顾性分析经16层螺旋CT增强扫描确诊42例患者的影像资料，其中包括13例为溶栓后复查病例，评价溶栓效果。结果肺动脉栓塞42例累及肺动脉及其分支187支，其CT表现直接征象有：中心性充盈缺损28支，偏心性充盈缺损61支，附壁性充盈缺损48支，完全阻塞性充盈缺损50例；间接征象包括肺门动脉增宽、局限性肺纹理稀疏、肺梗死、胸腔积液、心包积液等。13例溶栓后复查，均有所好转。结论16层螺旋CT增强扫描是一种安全、快捷、有效的诊断肺栓塞的无创性检查手段，可以直接观察到血栓累及的部位、表现形式在肺动脉栓塞的诊断及溶栓后复查中具有较高的临床应用价值。

Diagnosis of Pulmonary Embolism by 16-Slice Spiral CT Enhanced Scanning (Signs Analysis of 42 Cases)

Objective To study the CT signs and clinical using of pulmonary embolism （PTE） by 16- slice spiral CT enhanced scanning. Methods Images of 42 cases including 13 cases after thrombolysis diagnosed by 16-slice spiral CT enhanced scanning were retrospectively analyzed. Evaluat effect of thrombolysis. Results Among 42 patients, 187 vessels were involved with embolism. Direct signs of PTE：central filling defect 28 vessels, prejudicial filling defect 61 Vessels, embolism attached to the wall of host artery 48 vessels, and total occlusion 50 arteries; Indirect signs included pulmonary hypertension, lung-marking sparse, infarc- tion, pleural effusion and pericardium effusion. 13 cases after thrombolysis were improved. Conclusion 16- slice spiral CT enhanced scanning is an safe, accurate, and effective examination for the diagnosis and follow-up of PTE. embolus.