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目的探讨多层螺旋CT血管造影(CTA)对肺动脉栓塞的诊断价值,评价肺动脉栓塞CTA表现与疾病严重程度的关系。方法回顾性分析肺动脉栓塞36例临床和影像资料,所有患者均使用GELightSpeed64层螺旋CT或e-Speed电子束CT行常规扫描及CTA,横轴位图像和多种后处理技术观察肺动脉改变及相关征象。结果36例共2070支肺动脉纳入分析,748支显示了栓塞,占36.1%。216支肺叶动脉中,75支显示了栓塞(34.7%),720支肺段动脉中,319支显示了栓塞(44.3%),1134支亚段肺动脉中,354支显示了栓塞(31.2%)。根据临床表现将患者分为危重组和非危重组。危重组15例,肺动脉栓塞指数为(56.7±11.3)%,中央肺动脉受累39支(43.3%),右心室最大短轴和左心室最大短轴比(RV∶LV比)为(1.46±0.62)。非危重组21例,肺动脉栓塞指数为(27.4±9.6)%,中央肺动脉受累36支(28.6%),RV∶LV比为(1.06±0.35),两组指标测量结果差异均有统计学意义。结论多层螺旋CT血管造影可直观地显示有无肺动脉栓塞、病变范围和严重程度,肺动脉栓塞指数>40%可作为诊断大面积肺动脉栓塞的重要指标。
Objective To investigate the diagnostic value of multislice CT angiography (CTA) for pulmonary embolism and evaluate the relationship between the manifestation of pulmonary embolism and the severity of the disease. Methods A retrospective analysis of 36 cases of pulmonary embolism clinical and imaging data, all patients were used GELightSpeed64 layer spiral CT or e-Speed electron beam CT routine scanning and CTA, horizontal axis images and a variety of postoperative treatment of pulmonary artery changes and related signs . Results A total of 2070 pulmonary arteries were enrolled in 36 cases and 748 cases showed embolization, accounting for 36.1%. Among the 216 pulmonary arteries, 75 showed embolization (34.7%), of which 720 showed arterial embolization (31.3%), and 1134 pulmonary arteries showed embolism (31.2%). The patients were divided into critically ill group and non-critically ill group according to clinical manifestations. In the critically ill group, 15 cases had pulmonary embolism index (56.7 ± 11.3)%, 39 cases (43.3%) had central pulmonary artery involvement, (1.46 ± 0.62) in the right ventricle and left ventricle. . There were 21 cases in non-critically ill group, the pulmonary embolism index was (27.4 ± 9.6)%, the central pulmonary artery involvement was 36 (28.6%) and RV: LV ratio was (1.06 ± 0.35). There was significant difference between the two groups. Conclusion Multi-slice spiral CT angiography can visually indicate the presence or absence of pulmonary embolism, the extent and severity of the lesion, pulmonary embolism index> 40% can be used as an important indicator of large pulmonary embolism.