多层螺旋CT三种图像后处理技术在肺栓塞诊断中的应用评价  

Evaluate the clinical value of three-dimensional reconstruction imaging of 64-slice spiral CT in pulmonary em-bolism

作　　者：黄朝华[1] 杨江爽[1] 翁泽生[1] 吴先衡[1] 陈瑟燕[1] 林时勖[1] 

机构地区：[1]广东省汕头市中心医院,515031

出　　处：《实用医技杂志》2012年第8期800-802,共3页Journal of Practical Medical Techniques

摘　　要：目的比较不同重建层厚的各种图像后处理技术对肺动脉栓子的显示及诊断价值。方法收集40例经多层螺旋CT肺动脉成像检查并经临床及实验室检查确诊的肺动脉栓塞(PE)图像资料,利用原始数据分别行层厚0.625、1.25、2.5、5.0 mm重建图像,然后运用多平面重组(MPR)、最大密度投影(MIP)及容积成像(VR)3种图像后处理方法对于在不同层厚的各级肺动脉显示及其栓子分布情况进行观察分析。结果本组40例PE均为双肺多发肺栓塞,共累及各级肺动脉分支409处,范围从肺动脉主干至亚段动脉。40例PE中,对亚段动脉栓子检出率,0.625、1.25、2.5 mm MPR图像和MIP图像的差异无统计学意义,5 mm MPR、5 mm MIP及VR图像对亚段动脉栓子显示较0.625、1.25、2.5 mm MPR及MIP图像差异有统计学意义。结论肺栓塞的诊断主要依靠薄层横断图像,对亚段动脉栓子的观察至少要用2.5 mm重建层厚的MPR或MIP图像,两者任选择一项即可。而1.25 mm层厚对亚段动脉栓子不易漏诊,且能大大地提高观察者阅片速度,故1.25 mm层厚的MPR或MIP为最佳成像方法。Objective To compare the rate of embolus of well-visualized pulmonary arteries according to the anatomic level by using different reconstruction slice thickness with three-dimensional reconstruction imaging and analyze its diagnostic value. Methods Forty patients with pulmonary embolism （PE） defined by 64-slice spiral CT pulmonary angiography, clinical and the laboratory test were enrolled in this study. The muhi-planar reformation （MPR） and maximum intensity projection （MIP） technique with slice thicknesses of 0.625, 1.25, 2.5, 5.0 mm and volumetric rendering （VR） technique were obtained from each patient, then compared the abilities of showing the embolus in the pulmonary and the branches of four deferent slice thickness three-dimensional reconstructing imaging through MPR, MIP and VR. Results Forty cases were mani-fested as multiple pulmonary embolisms in bilateral lung,involved about 409 places in all levels of pulmonary artery branch, ranging from main pulmonary artery to subsegmental artery. Difference detection rate with 0.625, 1.25, 2.5 mm MPR, MIP image in subsegmental artery embolism was not statistically significant. Compared with the 5 mm MPR, 5 mm MIP, VR and 0.625, 1.25, 2.5 mm MPR, MIP, subsegmental arte~ embolus were bad visualized with the 5 mm MPR, 5 mm MIP,VR image that it has statistics difference. Conclusion Diagnosis of PE mainly depended on thin slice traverse imaging, at least 2.5 mm slice thickness or the thinner slice thickness with MPR or MIP imaging should be taken to ensure the subsegmental artery embolism is detected, and choose one of both is appropriate. 1.25 mm MPR or 1.25 mm MIP imaging are found not only to improve the rate of the subsegmental artery embolism, but also to enhance reading speed of observer, which are the best technology.

关 键 词：栓塞 胆固醇 体层摄影术 螺旋计算机 放射性核素血管显像术 图像处理 计算机辅助 

分 类 号：R563.5[医药卫生—呼吸系统]