64层MSCTPA于肺栓塞的诊断与应用  

Clinical Application of Multislice Computed Tomographic Pulmonary Angiography in the Diagnosis of Pulmonary Embolism

作　　者：王治国[1] 蔡俊[1] 王彩红[1] 

机构地区：[1]苏州大学附属太仓医院影像中心,江苏太仓215400

出　　处：《中国血液流变学杂志》2013年第4期778-779,785,共3页Chinese Journal of Hemorheology

摘　　要：目的：探讨64层螺旋CT肺血管造影（MSCTPA）行多平面重组对肺动脉栓塞的诊断价值、应用方法及临床治疗后的疗效评估价值。方法肺栓塞34例，经MSCTPA及临床明确诊断，回顾性分析其螺旋CT多平面重组表现；64层螺旋CT行薄层扫描，对原始数据进行重组分析。结果直接征象：偏心性充盈缺损、附壁环形充盈缺损、中心性充盈缺损、完全阻塞；间接征象：局限性肺纹理稀疏、肺动脉高压（或伴右心增大）、肺梗死（或伴肺不张）、“马赛克”征、胸腔积液、心包积液；治疗后14例复查，均有明显吸收或完全吸收。结论MSCTPA能及时、准确地诊断肺动脉栓塞，相较于其他检查有明显优势，对临床治疗有明确的指导意义及疗效评估价值，是快速、有效、安全的诊断方法。Objective To evaluate the clinical application and value of multislice computed tomographic pulmonary angiography （MSCTPA） in the diagnosis of pulmonary embolism （PE） and follow-up after treatment. Methods 34 patients with PE were examined with MSCTPA. The multiple planar reconstruction （MPR） combined with their clinical data were retrospectively analyzed. The initial data of the thin slice scan by 64-slice CT were re-combination analyzed. Results Direct sign：eccentric iflling defect, mural ring iflling defect, central iflling defect, total occlusion;Indirect sign：local pulmonary oligemia, pulmonary hypertension （or accompanied by right cardiac enlargement）, pleural effusion （or accompanied by atelectasis）,“Mosaic”sign, pleural effusion, pericardial effu-sion. After treatment, the follow-up examination showed that all the 34 cases had the pulmonary artery thrombus disappeared or mainly absorbed. Conclusion MSCTPA is a reliable and convenience examination for diagnosis of PE, and it has obvious advantages compared to other check, which is helpful to select the strategy of treatment.

关 键 词：肺动脉栓塞 MSCTPA MPR 充盈缺损 

分 类 号：R814.43[医药卫生—影像医学与核医学]