MSCT血管成像在肺动脉栓塞诊断中的价值

目的：探讨多层螺旋CT肺动脉血管成像（MSCTPA）在肺动脉栓塞中的诊断及临床应用价值。方法：对28例临床疑诊肺动脉栓塞的患者行MSCTPA检查,采用VR、MIP、MPR等多种后处理方法,分析所获得的影像资料,并结合临床资料进行回顾性分析。结果：28例患者中,经临床随访确诊肺栓塞26例;运用MSCTPA检出26例累及195支肺动脉,其中肺动脉主干0支,左、右肺动脉主干15支,叶肺动脉52支,肺段动脉82支,亚肺段动脉46支。195支肺动脉病变中表现为中心性充盈缺损为68支,占34.87%;偏心性充盈缺损为49支,占25.13%;混合型37支,占18.97%;完全梗阻性充盈缺损为41支,占21.03%。漏诊0例,误诊0例,诊断准确率达到100%。MSCTPA能全面地显示栓子的形态、位置、范围。结论：MSCTPA能准确的显示肺动脉栓塞及相关病变的影像表现,可成为肺动脉栓塞诊断的首选方法。

THE DIAGNOSTICAL VALUE OF MULTI-SLICE SPIRAL ANGIOGRAPHY(MSCTA) IN PULMONARY ARTERY EMBOLISM

Objective： To evaluate the clinical application of multi-slice spiral computer tomography pulmonary angiography（MSCTPA） in diagnosis of pulmonary embolism（PE）.Methods：Twenty-eight patients suspected of PE were examined by MSCTPA,and the images acquired by various post-processing techniques such as VR,MIP,MPR combined with their clinical data were retrospectively analyzed.Results： Twenty-six of the 28 patients were confirmed to have PE by clinical data and follow-up examination;195 pulmonary arteries involved branches in the 26 PE patients were discovered by MSCTPA,including 0 branches in pulmonary trunk,15 left and right pulmonary trunk,52 in lobar pulmonary arteries,82 in segmental pulmonary arteries,and 46 in subsegmental arteries.Four types of PE were detected in our group,including eccentric filling defect in 68 branches（34.87%）,central filling defect in 49 branches（25.13%）,mixed defect in 37 branches（18.97%）,and total occlusion of the pulmonary arteries in 41 branches（21.03%）.The diagnosis accuracy of MSCTPA in the present group of patients was 100%,with no missed diagnosis and misdiagnosis.Besides,MSCTPA reflected the morphology,location and involvement of PE.Conclusion： MSCTPA can accurately demonstrate PE and related pathological phantom change.It may become the first choiced method in diagnosing PE.