肺栓塞的多层螺旋CT诊断和溶栓治疗效果评价

目的探讨多层螺旋CT在肺动脉栓塞诊断和溶栓治疗效果评估中的作用。方法对52例临床拟诊肺动脉栓塞的患者行16层螺旋CT肺动脉成像(CTPA)检查,并对其中20例经溶栓治疗2周后的患者进行同机同条件复查。结果52例中8例肺动脉成像未见异常,1例为动静脉瘘,5例诊断为肺动脉高压,38例诊断肺动脉栓塞。38例肺栓塞中共累及各级肺动脉236处,其中肺动脉干5支,左右肺动脉30支,叶动脉81支,肺段动脉103支,亚段动脉17支。20例经溶栓治疗后复查,病灶均不同程度缩小或消失。结论16层螺旋CT能及时发现和诊断肺栓塞,也可指导溶栓治疗及评价疗效。

Evaluation of diagnosis and thrombolysis of pulmonary embolism by 16 slice spiral computed tomography

Objective To evaluate the diagnosis and thromblysis therapy of pulmonary embolism by 16 slice spiral computed tomography. Methods 52 patients suspected with the pulmonary embolism underwent 16 slice CT angiography. 20 cases of pulmonary embolism were followed-up with same examination method after thrombolysis therapy for 2 weeks. Results In 52 patients,8 cases revealed normal, 1 case with pulmonary arteriovenous fistula(AVF), 5 cases with pulmonary arterial hypertension , 38 cases with pulmonary embolism.236 lesions of 38 cases with pulmonary arteries embolism were detected, including main pulmonary arteries(n=5), left or right pulmonary arteries(n=30), lobar arteries(n=81), segmental vessel(n=103),and subsegmental arteries(n=17).After thrombolysis for 2 weeks,the PE was displayed as dissolution or disappearance in 20 cases . Conclusion MSCT angiography is an accurate and noninvasive method for detection and therapeutic follow-up of pulmonary embolism .