摘要
目的:探讨16层螺旋CT肺血管造影术(MSCTPA)诊断肺动脉栓塞的临床价值。方法:对临床拟诊肺栓塞的46例患者行MSCTPA检查及后重建技术,后重建方法包括容积再现(VR)、多平面重建(MPR)、最大密度投影(MIP)。结果:46例共发现栓子698个,其中肺动脉主干4个,左右肺动脉41个,叶动脉114个,段及亚段动脉539个。直接征象:①)血管截断征,表现为肺动脉管腔完全闭塞;②轨道征,表现为腔内充盈缺损位于血管中央,周围有对比剂环绕;③偏心性充盈缺损,表现为管腔内不规则充盈缺损偏向管壁一侧,边缘欠光整;④附壁性充盈缺损。间接征象:①肺窗观察见局限性的血管纹理稀疏,呈"马赛克征";②肺梗死,表现为肺外围以胸膜为基底的楔形或条状实变影;③胸腔积液、肺动脉高压、右心室肥大以及心包积液等。结论:MSCTPA能对肺动脉栓塞作出准确诊断,是无创、快速、安全、敏感的检查方法,并可追踪复查,评估治疗效果。
Objective：To explore the diagnostic value of 16-slice spiral CT pulmonary angiography（16-SCTPA）in diagnosing pulmonary embolism（PE）.Methods：46 patients suspected with PE were examined with 16-slice spiral CT pulmonary angiography.The raw data of 46 patients were reconstructed with the 3D techniques including multiplanar reconstruction（MPR）and maximum intensity projection（MIP）,all CT images features were analyzed.Results：698 embolus were found in 46 cases patients,The distribution of all the 698 pieces pulmonary emboli is 4 in main pulmonary artery,41 in left or right pulmonary artery,114 in lobar artery,539 in the segmental arteries and sub-segmental arteries.The direct signs of pulmonary embolism including：① ＂Truncation sign＂,showed complete occlusion of the lumen of pulmonary;② The central filling defect ＂double-track sign＂;③ Pulmonary artery lumen with eccentric filling defect;④ mural filling defect;The indirect signs including：① Partial sparse texture,that showing ＂mosaic sign＂ found in pulmonary window;② Pulmonary infarction,that showing wedge-shaped dense shadow in the lung periphery or showing strip dense shadow;③ Pleural effusion,pulmonary hypertension,right ventricular hypertrophy as well as the pericardial effusion and so on.Conclusion：MSCTPA able to make an accurate diagnosis of pulmonary embolism,and also be an non-invasive,rapid,safe and sensitive technology and can review to assess the therapeutic effect.
出处
《医学影像学杂志》
2010年第4期500-502,共3页
Journal of Medical Imaging
