64层螺旋CT肺动脉造影在肺栓塞诊断中的应用  

Application of 64-slice Spiral CT Pulmonary Arteriography in Diagnosis of Pulmonary Embolism

作　　者：罗小平[1] 张志平[2] 闵广斌 

机构地区：[1]南昌大学第三附属医院CT室,南昌330008 [2]南昌大学第三附属医院骨科,南昌330008 [3]江西江氨化学工业有限责任公司职工医院内科,南昌330012

出　　处：《实用临床医学（江西）》2011年第3期85-87,共3页Practical Clinical Medicine

基　　金：南昌市科技局(5)

摘　　要：目的利用64层螺旋CT肺动脉造影探讨肺动脉栓塞(pulmonary embolism,PE)的影像表现及其临床应用。方法对18例Wells评分在2分以上,且临床疑诊为PE的患者,使用64层螺旋CT肺动脉造影检查,进行多平面重建(MPR)、最大密度投影(MIP)和容积再现(VR)后外理。结果 18例均确诊为PE。PE的直接征象:18例患者均见肺动脉腔内充盈缺损改变。1)中央性充盈缺损,呈双轨征和靶征3例;2)偏侧性充盈缺损9例;3)附壁性充盈缺损3例;4)完全性阻塞3例。部分患者可见PE的间接征象:1)肺梗死4例;2)支气管动脉扩张3例;3)胸腔积液10例;4)右室功能不全1例。结论 64层螺旋CT具有快速、准确、无创伤等优点,能清晰显示PE的直接征象和间接征象,是临床明确PE诊断及评价疗效的首选方法。Objective To investigate the clinical application of 64-slice spiral CT pulmonary arteriography in diagnosis of pulmonary embolism（PE）.Methods Eighteen patients with suspected PE（Wells score〉2） underwent 64-slice spiral CT pulmonary arteriography.The post-processed images were generated by using multiplanar reconstruction（MPR）,maximum intensity projection（MIP） and volume rendering（VR）.Results The 18 suspected cases were diagnosed as PE.Diagnostic direct manifestations showed central in 3 cases,periphery in 9 cases,mural filling defects in 3 cases,and complete occlusion in 3 cases.Indirect signs showed pulmonary infarction in 4 cases,bronchial artery dilation in 3 cases,pleural effusion in 10 cases,and right ventricular dysfunction 1 case.Conclusion Sixty-four slice spiral CT arteriography is a rapid,accurate and non-invasive method for diagnosing PE,and can clearly show the direct and indirect signs of PE.Therefore,64-slice spiral CT arteriography can be used as the first choice in the diagnosis of PE and the evaluation of clinical efficacy.

关 键 词：64层螺旋CT 肺动脉造影 肺动脉栓塞 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563.5[医药卫生—诊断学]