双源CT肺动脉造影与双能量肺灌注成像诊断急性肺栓塞的对比研究  

Diagnostic value of dual energy CT lung perfusion imaging combined with CT pulmonary angiography in patients with acute pulmonary embolism

作　　者：吴京兰[1] 谭四平[2] 高德宏[2] 刘岩松[3] 杨新明[3] 张海钢[3] 周俊领[3] 肖水明[3] 洪全球[3] 庄瑞强[3] 

机构地区：[1]广东医学院附属深圳南山医院心内科,518052 [2]广东医学院附属深圳南山医院放射科,518052 [3]广东医学院附属深圳南山医院重症医学科,518052

出　　处：《中国心血管杂志》2011年第3期195-197,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨双源CT扫描时双能量肺灌注成像(DEPI)结合CT肺动脉造影(CTPA)对急性肺栓塞患者的诊断价值。方法选取我院2008年10月至2010年3月急性肺栓塞患者12例,应用双源CT进行平扫加增强扫描,先行CTPA,再用双能量扫描模式行肺灌注扫描,得出肺灌注图像及两种能量状态的融合图像,将CTPA上所示段及亚段肺血管内充盈缺损的位置、数目、类型与DEPI中肺灌注位置、数目、形态进行对比。结果当段、亚段肺血管为完全充盈缺损时,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84.4%(16支血管,7例)和63.6%(7支血管,5例)。而当部分充盈缺损时,肺灌注图像以不均匀灌注缺损为主,16%表现为无灌注缺损;相反,4个肺段区显示灌注缺损,而CTPA未见异常。结论双源CT肺灌注成像表现与CTPA上肺动脉栓塞程度、部位有关,两者联合有助于提高急性肺栓塞诊断率。Objective To investigate the diagnostic value of dual energy CT lung perfusion image （DEPI） combined with CT pulmonary angiography （CTPA） in patients with acute pulmonary embolism. Methods The clinical data of 12 patients with acute pulmonary embolism were retrospectively analyzed. All of them underwent contrast CT scan in two phases using dual energy CT, firstly pulmonary artery phase and secondly dual energy scan covered the whole lung. Perfusion defects in DEPI were compared with the filling defects in CTPA. Results Most of the complete filling defects in segmental and subsegmental pulmonary arteries in CTPA associated with perfusion defects in CT perfusion map. And partial filling defects in CTPA often coincided with partial perfusion defects in DEPI. Segmental perfusion defects in DEPI without filling defect occurred in 4 patients. Conclusions The combination of CTPA and DEPI will offer more information in the diagnosis of the acute pulmonary embolism.

关 键 词：体层摄影术 X线计算机 再灌注损伤 血管造影术 肺栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]