支气管动脉栓塞术前64层螺旋CT血管成像检查对诊疗大咯血的价值  

The value of 64-section multi-detector row CT for the evaluation of bronchial artery embolization in the diagnosis and treatment of hemoptysis

作　　者：张鸿文[1] 杨熙章[1] 陈自谦[1] 杨永岩[1] 杨利[1] 史震山[1] 林宇宁[1] 雷娟[1] 

机构地区：[1]南京军区福州总医院医学影像科介入病房,福建福州350025

出　　处：《临床肺科杂志》2010年第6期771-773,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的支气管动脉栓塞术(Bronchial artery embolization,BAE)前进行64层螺旋CT血管成像(CT angiography,CTA)检查对大咯血的诊疗价值。方法回顾性40例在BAE前进行CTA检查的大咯血患者,对咯血责任血管进行分析,然后将检查结果与BAE术中数字减影血管造影(digital subtraction angiography,DSA)检查结果相对比。结果大咯血常见病因为支气管扩张、肺癌、肺结核;CTA与DSA共检出69支咯血责任血管,CTA检出64支,检出率92.75%;CTA与DSA同时检出63支咯血责任血管,符合率98.43%;DSA检出10例支气管动脉-肺动静脉瘘,CTA不能检出。对于咯血责任血管的起源检出,在支气管动脉系统及肺动脉系统符合率高。结论 CTA不仅具有CT增强的诊断功能,有助于临床和介入医生对因治疗,还能为BAE治疗提供咯血责任血管的起源及走行,提供准确定位,减少术中时间和辐射剂量,可作为术前首选的常规检查方法 。Objective To investigate the value of 64-section multi-detector row CT（CTA） for the evaluation of bronchial .artery embelization（BAE）in the diagnosis and treatment of hemoptysis. Methods 40 cases of hemoptysis whose CTA images acquired before BAE were retrospeetively analyzed and post-processed for responsible vessels, which were then compared with corresponding DSA images obtained after BAE. Results The common cause of hemoptysis was bronchieetasis, lung cancer and pulmonary tuberculosis. CTA and DSA detected 69 vessels responsible for hemoptysis,64 of which were detected by CTA with a detection ratio of 92.75%. 63 responsible vessels were both detected by CTA and DSA with a eoincidenee ratio of 98.43%. DSA deteeted 10 cases of branchial artery-pulmonary artery/vein fistula, whieh CTA did not. For the detection of origin of responsible vessels in both system of branchial artery and pulmonary artery was in high accord. Conclusion CTA could provide not only information of contrast CT for the etiological treatment by clinical and intcrventional doctors, but also information of origin, eourse and precise location of hemoptysis responsible vessels before BAE. Therefore CTA should be taken as a routine examination before BALE to reduce operation time and radiation dose.

关 键 词：咯血 CT血管成像 数字减影血管造影 支气管动脉栓塞术 

分 类 号：R56[医药卫生—呼吸系统]