CT肺血管造影联合下肢CT静脉造影检查在疑诊下肢深静脉血栓患者中的应用  

Application of MSCT pulmonary angiography in combination with CT venography in patients with suspected deep venous thrombosis

作　　者：王占鳌[1] 袁玉春[1] 朱力[2] 田兴仓[2] 李文玲[2] 穆丽莎[1] 

机构地区：[1]宁夏医科大学研究生院,宁夏银川750004 [2]宁夏医科大学总医院放射科

出　　处：《实用放射学杂志》2012年第3期436-440,共5页Journal of Practical Radiology

基　　金：国家＂十一五＂科技攻关项目（编号：2006BAI01A06）;国家自然基金资助项目（30960098）;宁夏科技攻关计划资助项目;宁夏医科大学重点资助项目（XZ201008）.

摘　　要：目的 评价64层螺旋CT肺血管造影（CTPA）联合下肢CT静脉造影检查（CTV）,在下肢深静脉血栓（DVT）中的诊断作用.方法 连续收集临床上疑似下肢深静脉血栓并行64层螺旋CTPA联合下肢CTV检查的患者.按照CTPA和CTV检查的图像质量进行筛选.根据患者肺动脉和下肢深静脉内是否存在血栓进行分析,并对下肢静脉内血栓最近端位置进行统计.最终有109例患者纳入研究.结果 肺动脉和下肢静脉内同时有血栓的患者39例,单纯急性肺血栓患者1例,单纯DVT患者57例,肺动脉和下肢静脉内均无血栓的患者12例.DVT患者血栓最上端位于下腔静脉14例,位于盆腔髂静脉63例,位于大腿（股腘静脉）13例,位于小腿（胫腓静脉）6例.结论 64层螺旋CTPA联合下肢CTV检查对DVT疑似患者的肺动脉内血栓检出具有重要意义,避免了36.7%患者中肺动脉内血栓的漏诊.Objective To study the value of CT venography（CTV） in combination with CT pulmonary angiography（CTPA）using MSCT in diagnosis of deep venous thrombosis（DVT） of lower limb. Methods 109 patients with clinically suspected DVT underwent combined CTPA and CTV examinations. CTV and CTPA images were analysed and the proximal localizations of the embolus in low er extremity venous were also evaluated. Results There were 39 patients with both pulmonary embolus（PE） and DVT at the same patient, 1 patient only with auct PE and 57 patients only with DVT, 12 patients had neither PE nor DVT. For DVT,the proximal localizations of embolus located at inferior vena cava in 14 cases,iliac vein in 63 cases, femoropopliteal vein in 13 cases and tibiofibular vein in 6 cases. Conclusion CTV in combination with CTPA is of significance in detecting the patients suspected with pulmonary ar tery embolus,which can provide information to avoid PE missed in 36.7% patients.

关 键 词：肺 血管造影 体层摄影术 X线计算机 深静脉血栓 肺栓塞 

分 类 号：R814.43[医药卫生—影像医学与核医学] R814.42[医药卫生—放射医学]