CT肺动脉及支气管动脉联合造影对咯血患者的诊断价值  

The evaluation of combined CT pulmonary and bronchial arteriography for the diagnosis of hemoptysis

作　　者：米崧[1] 张黎明[1] 毛文苹[1] 焦霞[1] 薛熠[1] 杭燕[1] 吕秀华[1] 

机构地区：[1]首都医科大学附属北京朝阳医院北京呼吸疾病研究所京西院区呼吸与危重症医学科,100043

出　　处：《中华结核和呼吸杂志》2012年第1期42-44,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨建立CT肺动脉（PA）及支气管动脉（BA）联合造影的方法及其对咯血患者的诊断价值。方法连续纳入北京朝阳医院2007年6月至2009年7月36例中等量及以上咯血住院患者，其中男21例，女5例，年龄27～83岁，平均（56±14）岁。使用16排螺旋CT，静脉注射对比剂后，首先完成CT肺动脉造影（CTPA），延迟时间12～16s，继之完成CT支气管动脉造影（CTBA），延迟时间26～28s，经图像重建后对PA及BA进行评价。结果36例患者CTPA检查发现7例PA异常（肺栓塞3例，PA畸形、原发性PA平滑肌肉瘤、PA边缘模糊及右下PA闭塞各1例）。36例患者CTBA检查共显示37支右侧BA，其中11支迂曲增粗、40支左侧BA及3支非支气管体循环动脉，其中来源于腹主动脉的1支迂曲增粗。异常血管与肺部疾病关系密切。结论利用16排螺旋CT技术，可进一步完成CTPA及CTBA检查，清楚显示异常的PA及BA，对咯血的诊断及治疗具有重要价值。Objective To establish the method of muhi-slice spiral CT pulmonary angiography （CTPA） combined with bronchial angiography（CTBA） and to evaluate its value for diagnosis and treatment in hemoptysis. Methods After contrast material was administered intravenously, a 16-detector row helical CT scanner （Light Speed Ultra 16; GE Medical Systems） was used to complete CTPA first with a scan delay time of 12 - 16 s. Then CTBA was carried out, with a scan delay time of 26 - 28 s. The images were reformatted to evaluate the pulmonary artery and bronchial artery （BA）. Results In 36 cases of hemoptysis, CTPA showed 7 pulmonary arterial abnormalities （ 3 cases with pulmonary embolism, 4 cases with one of pulmonary artery abnormity, primary pulmonary artery leiomyosarcoma, loss of sharpness of pulmonary artery or occlusion of right-inferior lung artery）. In the 36 cases, CTBA showed 37 right BAs （11 tortuosity and thickening） ,40 left right BAs（ 10 tortuosity and thickening）and 3 non-bronchial systemic arteries（ 1 from abdominal aorta tortuosity and thickening）. Abnormal vessels had a close relation with pulmonary diseases. Conclusions With this method CTPA and CTBA can be completed in a single procedure and abnormal pulmonary arteries and bronchial arteries can be shown clearly. This procedure maybe of important value for the diagnosis and treatment of hemoptysis.

关 键 词：咯血 血管造影术 肺动脉 支气管动脉 

分 类 号：R56[医药卫生—呼吸系统]