论文部分内容阅读
目的分析肺栓塞的X线平片、CT平扫及CT肺血管造影(CT pulmonary angiography,CTPA)表现,探讨三者在PE中的诊断价值。方法对经临床综合诊断的480例PE的临床及影像资料进行回顾性分析,着重探讨PE的X线平片、CT平扫及CT肺血管造影表现及临床应用价值。结果 480例PE中,65例X线有轻微异常,表现为肺浸润影、少量胸腔积液、肺不张、心脏增大、肺动脉高压;215例CT平扫可见异常,表现为栓塞区的肺血流的低灌注、肺血流的不均匀灌注(马赛克灌注)以及栓塞肺动脉血管内局部直径及密度异常,栓塞较严重者可见肺体积的减小、右心影增大、肺动脉高压、腔静脉增粗;480例CTPA均显示异常,表现为栓塞肺动脉的充盈缺损、栓塞远端肺动脉变细、肺血流的低灌注及不均匀灌注、侧枝循环形成以及近心端肺动脉高压、心影增大。结论肺栓塞的X线平片、CT平扫及CT肺血管造影均可出现异常表现,在三种影像诊断方法中以CTPA最为确切,X线平片及CT平扫出现异常几率较小且其征象无明确的特异性,但一旦出现这些征象可提示疑诊,为进一步进行CTPA检查提供参考。
Objective To analyze the manifestations of X-ray, CT plain scan and CT pulmonary angiography (CTPA) of pulmonary embolism in the diagnosis of PE. Methods Retrospective analysis was performed on the clinical and imaging data of 480 PE patients diagnosed clinically. The clinical manifestations and clinical value of PE plain radiography, CT plain CT and CT pulmonary angiography were discussed. Results Among the 480 PE cases, 65 cases had mild X-ray abnormalities, including pulmonary infiltrates, a small amount of pleural effusion, atelectasis, cardiac enlargement and pulmonary hypertension. The CT scan of 215 cases showed abnormalities as pulmonary embolism Low perfusion of blood flow, uneven perfusion of the pulmonary blood flow (mosaic perfusion), and local diameter and density abnormalities in the embolized pulmonary artery. Severe embolism can be seen reduced lung volume, increased right heart shadow, pulmonary hypertension, Thickening; 480 cases of CTPA showed abnormalities, manifested as embolization of the pulmonary artery filling defect, pulmonary embolism distal pulmonary thinning, hypoperfusion and uneven perfusion of the pulmonary blood flow, collateral circulation and proximal pulmonary hypertension, increased heart shadow . Conclusions X-ray, CT scan and CT pulmonary angiography of pulmonary embolism can all show abnormalities. Among the three imaging diagnostic methods, CTPA is the most accurate and X-ray and CT plain anomalies are rare No specific signs of specificity, but once these signs can be prompted to suspect, provide a reference for further CTPA examination.