前瞻性心电触发大螺距CT肺动脉成像对肺栓塞的诊断价值  

The Diagnostical Significance of Dual-source CT Angiography with Prospectively Electrocardiogram-triggered High-pitch Spiral Protocol in Pulmonary Embolism

作　　者：孙喜霞[1] 季颖群[2] 贾崇富[1] 郑飞[1] 王照谦[1] 杨志强[1] 

机构地区：[1]大连医科大学附属第一医院心脏CT检查科,辽宁大连116011 [2]大连医科大学附属第一医院呼吸科,辽宁大连116011

出　　处：《中国医科大学学报》2013年第2期156-159,共4页Journal of China Medical University

基　　金：十二五"国家科技支撑计划项目(2011BAI11B15)

摘　　要：目的探讨第2代双源CT前瞻性心电触发大螺距扫描(Flash模式)肺动脉成像对肺栓塞的诊断价值。方法回顾性分析19例行双源CT前瞻性心电触发大螺距扫描肺动脉成像并诊断为肺栓塞患者的影像资料,总结肺栓塞的直接、间接征象及分型。结果 19例肺栓塞共显示肺动脉1 614支,发现栓子381支,栓塞发生率为23.6%。381支栓子中累及肺动脉主干1支,左右肺动脉干7支,叶肺动脉16支,段肺动脉83支,亚段肺动脉274支。直接征象为肺动脉管腔内的充盈缺损,其中中心型113支(占29.7%),偏心型24支(占6.3%),混合型8支(占2.1%),闭塞型236支(占61.9%)。间接征象包括马赛克征1例,肺梗死2例,肺动脉高压1例,胸腔积液7例。结论双源CT前瞻性心电触发大螺距扫描肺动脉成像简单、快捷、安全、无创,可清晰显示肺动脉栓子,对诊断肺栓塞有重要价值。Objective To evaluate the significance of second-generation dual-source CT angiography with prospectively ECG-triggered high- pitch spiral protocol （Flash mode） in the diagnosis of pulmonary embolism. Methods The patients with pulmonary embolism of 19 cases using second-generation dual-source CT with prospectively ECG-triggered high-pitch spiral protocol were analyzed retrospectively. The direct signs,indirect signs and types of pulmonary embolism were summarized. Results A total of 1 614 branches of pulmonary arteries were dis- covered in the 19 patients. A total of 381 embolisms were discovered by dual-source CT. Incidence of embohsm was 23.6%. The 381 pul- monary embolism involved 1 branch in pulmonary trunk, 7 in left and right pulmonary trunk, 16 in lobar pulmonary artery, 83 in segmental pulmonary artery, and 274 in subsegmental pulmonary artery. The direct signs of pulmonary embolism were filling defect in pul^nonary artery, including central filling defect in 113 branches （29.7%）,eccentric filling defect in 24 branches （6.3%）,mixed defect !in 8 branches （2.1%） ,complete occlusion of pulmonary arteries in 236 branches （61.9%）. The indirect signs included 1 case of mosaic sign,2 cases of pulmonary infarction, 1 case of pulmonary hypertension, and 7 cases of pleural effusion. Conclusion The prospectively ECG-triggered high- pitch spiral acquisition of dual-source CT angiography is a convenient,fast,safe,non-invasive and reliable method for demonstration of pul- monary embolism and plays an important role in the diagnosis of pulmonary embolism.

关 键 词：肺栓塞 体层摄影术 X线计算机 血管造影术 

分 类 号：R563.5[医药卫生—呼吸系统]