急性肺栓塞双能CT肺灌注影像表现与CT肺动脉造影的比较  

Radiological Features of Dual-energy CT Lung Perfusion Imaging in Patients with Acute Pulmonary Embolism:Comparison with CT Pulmonary Angiography

作　　者：张燕[1] 张竹花[1] 金征宇[1] 薛华丹[1] 张小娜[1] 梁继祥[1] 张云庆[1] 徐凯[1] 齐冰[1] 赵文敏[1] 王沄[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《中国医学科学院学报》2009年第2期166-170,I0006,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨急性肺栓塞患者双能CT扫描肺灌注缺损类型与CT肺动脉造影(CTPA)中肺动脉充盈缺损类型的关系。方法22例急性肺栓塞患者应用双源CT先行CTPA,然后用双能扫描模式行肺灌注扫描,将CTPA上所示段及亚段肺血管内充盈缺损形态与CT肺灌注图像的肺灌注缺损相对照。结果当段、亚段肺动脉肺栓塞充盈缺损为完全型时,相应的肺灌注图像主要是肺段或亚段分布的灌注缺损,分别占83%、62%。而当充盈缺损为部分或中央型充盈缺损时,肺灌注图像以部分型灌注缺损或无灌注缺损为主,3个肺段区肺灌注图像显示灌注缺损,而CTPA未见异常。结论CT肺灌注缺损与CTPA上肺动脉充盈缺损不能一一对应,两者联合起来将会为急性肺栓塞提供更多的信息。Objective To explore the relationship of the perfusion defects in the dual-energy CT lung perfusion image and the filling defects in the CT pulmonary angiography （CTPA） in patients with acute pulmonary embolism. Methods The clinical data of 22 patients with acute pulmonary embolism were retrospectively analyzed. All of them underwent contrast CT scan in two phases using dual-energy CT： the first is pulmonary artery phase, and the second was performed immediately after the first phase using dual-energy scan covered the whole lung. Perfusion defects in the lung perfusion images were compared with the filling defects in the CTPA.Results Complete filling defects of segmental and subsegmental pulmonary arteries mostly showed correspondence perfusion defects in the CT perfusion map, accounting for 83% and 62% respectively. However, when there were partial or central filling defects, most of them were partial perfusion defects or normal in the CT perfusion map. Three segmental perfusion defects were depicted without the visualization of endoluminal thrombi within the corresponding arteries. Conclusions The perfusion defects in the CT lung perfusion image are not completely corresponding to the filling defects in the CTPA. The combination of CTPA and CT lung perfusion map will offer more information for the acute pulmonary embolism.

关 键 词：肺栓塞 双能CT 血管造影术 

分 类 号：R814.42[医药卫生—影像医学与核医学]