多层螺旋CT对脓毒性肺栓塞滋养血管征的评价.docVIP

PAGE PAGE 1 多层螺旋CT对脓毒性肺栓塞滋养血管征的评价 韦建林 郭兴 李炳灿 莫婧（广西医科大学第四附属医院放射科 广西柳州 545005） 摘要 目的 运用多层螺旋CT研究评价肺血管与脓毒性肺栓塞滋养血管征之间关系。材料与方法 采用双盲法由两名观察者回顾性分析11例SPE与10例病理证实癌症的肺转移病人MDCT图像，通过横断面、MPR（多维平面重建）、MIP（最大密度投影）分析肺结节与肺血管关系，滋养血管征定义为一支血管直接伸入结节。结果 SPE病人发现91个结节和32个楔形阴影。其中横断位图像显示36（40%）个结节和8（25%）个楔形阴影有血管进入结节，而在MPR（未静脉对比增强）和MIP（静脉对比增强）显示这些血管绕行结节周围。在所有的成像中，14(15%）个结节和4(13%)个楔形阴影显示血管进入病灶。在横断位像所有这些血管汇入左心房与肺静脉征象一致；在肺转移病人也发现相似征象。结论脓毒性肺栓塞在横断位图像经常能显示滋养血管，但是MPR能显示大多数滋养血管环绕结节走行，其中有些为肺静脉。 关键词 脓毒性肺栓塞，多层螺旋CT MDCT for evaluation of the feeding vessel sign in septic pulmonary embolism（Wei Jianlin，Guo Xing，LI Bingcan，et al. Radiology Department， the Fourth Affiliated Hospital of Guangxi Medical University， Liuzhou，Guangxi 545005，China） [Abstract] Objective. The objective of this study was to use MDCT to assess the relation of the pulmonary vasculature to septic pulmonary embolism with particular attention to the feeding vessel sign. MATERIALS AND METHODS. The MDCT scans of 11 patients with septic emboli were retrospectively, blindly evaluated by two observers. A control group of 10 patients with documented pulmonary metastasis and pathologically proven carcinoma also were included. Transverse images, multiplanar reconstructions, and maximum intensity projections were used to analyze nodules and the pulmonary vasculature. The feeding vessel sign was defined as a vessel coursing directly into a nodule. RESULTS. The patients with pulmonary septic embolism had a total of 91 nodules and 32 wedge-shaped opacities. Transverse images showed that 36 (40%) of the nodules and 8 (25%) of the wedge-shaped opacities had a vessel that appeared to enter the nodule, but multiplanar reconstructions (without IV contrast enhancement) and maximum intensity projections (with IV contrast enhancement) showed the vessels passed around the nodules. Fourteen (15%) of the spherical nodules and four (13%) of the wedge-shaped opacities exhibited a central vessel entering the lesion in all imaging planes. All of these vessels we