急性肺栓塞MSCTPA诊断价值及其临床应用探究.docVIP

急性肺栓塞MSCTPA诊断价值及其临床应用探究 　【摘要】 目的：评价MSCTPA对急性肺栓塞的临床诊断价值。方法：采用16层螺旋CT触发扫描技术对36例急性肺栓塞患者行MSCTPA检查，其中6例可疑下肢静脉血栓患者在完成胸部扫描后延迟170 s行下肢扫描，容积数据传送至工作站后分别行多平面重建（MPR）、最大密度投影（MIP）、容积再现（VR）及仿真内窥镜（CTVE）成像。结果：36例共显示了1 564支肺动脉，栓塞的肺动脉682支,占43.8%，下肢静脉血栓4例。肺栓塞的直接征象为管腔狭窄、阻塞、分支减少及血管腔内的低密度充盈缺损，间接征象为肺梗死灶形成、胸腔积液、肺炎、肺不张、肺动脉增宽、心包积液等。结论：MSCTPA三维成像能够准确、直观地显示肺动脉解剖及栓子部位，是急性肺栓塞安全、迅速、无创的有效诊断方法。 【关键词】 多层螺旋CT；血管造影；图像处理；肺栓塞 　　Diagnosis and Clinical Research for the MSCTPA of Acute Pulmonary Embolism 　　Abstract：Objective To evaluate the diagnosis value of MSCTPA in acute pulmonary embolism.Methods 36 acute Pulmonary embolism patients were examined by technique that concentrateion of contrast medium controls the scanning of 16slice spiral CT.Among them,6 suspected of phlebothrombosis was given lower limb scanning in 170 seconds after thorax scanning.Volume data was transmitted to the work station and the reconstruction of multiplanar reformations(MPR),maximum intensity projection(MIP)，volume rendering(VR) and virtual endoscopy(CTVE).Results The 36 with displayed 1 564 pulmonary arteries,with 682 embolic,making 43.8%,with 4 venous thrombosis of the lower limbs.The direct signs of Pulmonary embolism were luminal constriction,emphraxis,branched decreased,intraluminal lowD filling defect of blood vessel;while the indirect signs,formation of pulmonary infarction focus,pleural effusion,pneumonia,atelectasis,pulmonary dilatation and hydropericardium,etc.Conclusion MSCTPA and 3D images plan an important role in the vivid recognition of the anatomica charactures of pulmonary arteries and sites of thrombosis.This is a safe,quick and effective imagilogic examination for acute Pulmonary embolism. 　　Key words：Multislice spiral CT;Angiography;Image Processing;Pulmonary embolism 　　肺栓塞是一种严重危害人类健康的心血管疾病,近年来发病率有上升的趋势。该病起病急,病程进展迅速,如诊断及治疗不及时,患者死亡率较高.随着多层螺旋CT肺血管造影(MSCTPA)技术在临床的广泛运用,安全、快捷及大范围的容积扫描结合多种成像技术为肺栓塞的正确诊断提供了丰富的影像信息。本文回顾性分析36例急性肺栓塞的病例资料，探讨MSCTA多种成像技术在临床诊断中的应用价值。 　　1 材料与方法 　　1.1 临床资料 本组36例中，男22例,女14例,年龄46岁～89岁，平均