论文部分内容阅读
目的探讨MSCT肺血管造影对肺栓塞的诊断价值。方法Ⅰ组25例采用2.5 mm准直,3.2 mm层厚扫描。Ⅱ组10例采用1 mm准直,1.3 mm层厚扫描。2组中5例患者在MSCTPA后行下肢深静脉扫描。结果2组对主肺动脉、叶肺动脉显示无差异,对段、亚段及5级分支显示,1 mm准直优于2.5 mm准直。MSCTPA显示受累肺动脉486支,肺动脉充盈缺损包括中心型(276支),锐角附壁型(87支),钝角附壁型(12支),完全附壁型(111支)。急性肺栓塞31例,慢性肺栓塞4例。间接征象包括肺梗死、肺少血征、马赛克征、胸腔积液、主肺动脉和/或叶肺动脉扩张、右心室增大、室间隔移位等。CTV显示双侧股静脉栓塞3例,单侧股静脉及股深静脉栓塞2例。结论多层螺旋CT肺血管造影能清楚显示肺栓塞的直接征象及间接征象,1 mm准直薄层扫描能发现更多外围肺动脉栓塞,MSCTPA与CTV联合成像有助于肺栓塞的确诊。
Objective To investigate the diagnostic value of MSCT pulmonary angiography in pulmonary embolism. Methods Ⅰ group 25 cases with 2.5 mm collimation, 3.2 mm layer thickness scan. Group Ⅱ 10 cases using 1 mm collimation, 1.3 mm layer thickness scan. Five patients in group 2 underwent deep venous and deep vein scanning after MSCTPA. Results There was no difference between the two groups on the main pulmonary artery and the pulmonary artery. The segment, sub-segment and grade 5 branch showed that 1 mm alignment was better than 2.5 mm alignment. MSCTPA showed 486 pulmonary arteries involved. Pulmonary artery filling defects included central type (276), acute angle (87), obtuse angle (112) and complete wall type (111). 31 cases of acute pulmonary embolism, 4 cases of chronic pulmonary embolism. Indirect signs include pulmonary infarction, pulmonary hypomagneseses, mosaic signs, pleural effusion, dilatation of the main pulmonary and / or pulmonary arteries, right ventricular enlargement, and ventricular septal transposition. CTV showed bilateral femoral vein thrombosis in 3 cases, unilateral femoral vein and deep vein thrombosis in 2 cases. Conclusions Multi-slice CT pulmonary angiography can clearly show the direct and indirect signs of pulmonary embolism. More peripheral pulmonary embolism can be found by 1 mm collimation and thin-slice scanning. The combined imaging of MSCTPA and CTV is helpful for the diagnosis of pulmonary embolism.