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目的:介绍多排螺旋CT血管造影诊断静脉血栓栓塞的扫描技术和影像学征象,评价其在静脉血栓栓塞早期诊断中应用价值和优势。方法:应用计算机检索Medline1998-01/2007-10与静脉血栓栓塞和肺血栓栓塞的诊断相关的英文文章,检索词“venous thromboembolism,pulmonary thromboembolism,CT angiography”;同时通过手工和计算机检索万方数据库2000-01/2007-10相关中文文章,检索词“静脉血栓栓塞,CT血管造影,诊断”。通过检索得到228篇相关文献,纳入24篇完全符合要求的文献。结果:多排螺旋CT利用多排采集技术,结合高质量的三维重建图像,能清晰地显示肺动脉远端分支,使肺栓塞的诊断进一步达到了亚段水平。薄层螺旋CT诊断肺栓塞的敏感性与肺动脉血管造影相比没有显著差异,其敏感性和特异性都高于肺通气/灌注核素扫描,且在排除急性肺栓塞时,螺旋CT有可能替代核素扫描成为检查的首选。结论:螺旋CT扫描速度快,图像清晰,不遗漏小病灶。螺旋CT血管造影是静脉血栓栓塞安全、迅速、无创伤的有效诊断方法。
Objective: To introduce the multi-slice spiral CT angiography in the diagnosis of venous thromboembolism scanning technology and imaging signs, to evaluate its value in the early diagnosis of venous thromboembolism and its advantages. Methods: The English articles about the diagnosis of venous thromboembolism and pulmonary thromboembolism by Medline from January 1998 to October 2007 were searched by computer, and the words “venous thromboembolism, pulmonary thromboembolism, CT angiography” were searched. Meanwhile, Wanfang Database 2000-01 / 2007-10 related Chinese articles, search term “venous thromboembolism, CT angiography, diagnosis ”. A total of 228 related articles were obtained by searching, and 24 articles were fully met. Results: Multislice spiral CT combined with high-quality three-dimensional reconstruction images can clearly show the distal branches of pulmonary arteries using multi-row acquisition technique, and the diagnosis of pulmonary embolism further reaches the sub-level. The sensitivity and specificity of thin-slice spiral computed tomography in the diagnosis of pulmonary embolism were not significantly different from those of pulmonary angiography, and were higher than that of pulmonary ventilation / perfusion nuclide scanning. Spiral CT may be an alternative to acute pulmonary embolism Radionuclide scanning became the first choice of examination. Conclusion: Spiral CT scanning speed, clear images, missed a small lesion. Spiral CT angiography is a safe, rapid, non-invasive and effective diagnostic method for venous thromboembolism.