64排螺旋CT对肺动脉血栓栓塞临床应用价值.docVIP

64排螺旋CT对肺动脉血栓栓塞临床应用价值 　　[摘要] 目的：探讨64排螺旋CT血管造影对肺动脉血栓栓塞的诊断价值。方法：确诊为PTE的57例患者，均行肺动脉CTA检查，并对原始数据进行多平面重组（MPR）、最大密度投影（MIP）以及三维容积成像（VR）后处理。结果：57例患者CTA均显示肺栓塞的分布范围、栓塞部位及局部管腔狭窄程度，直接征象表现为肺动脉内充盈缺损，如中心性、偏心性或完全阻塞性；间接征象表现为肺动脉高压、中心肺动脉增宽、右心增大、胸腔积液、心包积液及肺梗死等。结论：64排螺旋CT血管造影是临床诊断肺动脉栓塞的无创性首选方法。 　　[关键词] 肺栓塞；64排螺旋CT；血管造影；多平面重组 　　[中图分类号] R445.3 [文献标识码] B [文章编号] 1673-7210（2011）06（c）-106-03 　　 　　The clinical value of 64-slice spiral Computed Tomography in pulmonary thromboembolism 　　LU Wenwu1, LU Yunmei2* 　　1.Department of CT, the First Affilicated Hospital of Baotou Medical College, Baotou 014010, China; 2.Department of Ultrasonic Diagnosis, the First affilicated hospital of Baotou Medical College, Baotou 014010, China 　　[Abstract] Objective: To investigate the diagnositic value of 64-slice spiral CT angiography (CTA) in pulmonary thromboembolism. Methods: 57 patients with clinically known PTE underwent pulmonary arterial CTA. The sourse image of all patients were postprocessed by multiple planar reformation (MPR), maximum intensity projection（MIP） and volume rendering (VR). Results: CTA showed clearly the location and range of emboli and stenosed lumens of PTE in all patients, Direct signs showed filling defects, such as central filling defects of 30 arteries, partial filling defects of 66 arteries and obstructive of 9 arteries; Indirect signs represented as the dilating of right ventrical and central pulmonary arteries, pleural effusion, pericardial effusion, pulmonary infaction and so on. Conclusion: 64-slice spiral CT angiography is the first choice and non-invasive method for the dianosis of PTE. 　　[Key words] Pulmonary thromboembolism; 64-slice spiral CT; Angiography; Multiple planar reformation 　　 　　肺动脉血栓栓塞（pulmonary thromboembolism，PTE）是指内源性或外源性栓子栓塞肺动脉或其分支引起肺循环障碍的综合征。可以并发出血或坏死称为肺梗死。造成肺动脉栓塞的栓???主要成分是血栓。多数肺栓塞患者无明显临床症状，部分患者可有突发胸痛和呼吸困难，严重者休克和死亡。在我国肺动脉栓塞发病率有增加的趋势，其危害大，病死率高，漏诊、误诊率亦高[1]，而早期诊断并及时治疗可使病死率下降。随着多排螺旋CT（multisliice detector CT，MDCT）的应用，本病常能早期作出明确诊断。本文通过分析我院2008年1月～201