目的 探讨双源CT肺动脉成像在急慢性肺动脉栓塞鉴别中的诊断价值.方法 回顾性分析64例确诊急性肺动脉栓塞患者治疗前、治疗后15 d—3个月CT肺动脉成像资料,结合临床、超声及实验室检查对图像进行综合分析.结果 26例患者复查确诊为慢性肺动脉栓塞,急慢性肺动脉栓塞累及1级、2级、4级肺动脉分支数差异有统计学意义 (P ＜0.05),急性肺动脉栓塞患者中充盈缺损形态以完全和中心充盈缺损为主,慢性肺动脉栓塞患者中以附壁充盈缺损为主 (P ＜0.001);急慢性肺动脉栓塞肺动脉分支减少出现率差异有统计学意义 (P ＜0.05);间接征象急慢性肺动脉栓塞对比分析差异无统计学意义 (P＞ 0.05).结论 根据直接征象双源CT肺血管成像能较准确地判定急慢性肺动脉栓塞,对临床治疗具有一定指导意义.%Objective To investigate into the value of dual-source computed tomography (DSCT) and pulmonary angiography (CTPA) in detecting acute and chronic pulmonary embolism (PE) . Methods Totally 64 patients confirmed with acute PE, who underwent CTPA examination before treatment and 15 days to 3 months after treatment, were retrospectively analyzed. This study was combined with clinical, ultrasound and laboratory examination, in order to make a comprehensive analysis of the CTPA images. Results 26 patients were confirmed with chronic PE after review. Acute or chronic PE involvement level 1, level 2, level 4 and their pulmonary artery branch number was statistically significant (P ＜ 0.05) . The direct signs of acute PE included complete and central filling defect, while in patients with chronic PE with the attached wall filling defect (P ＜ 0.001) . The incidence rate of pulmonary artery branch reduction in acute and chronic PE was different (P ＜ 0.05) . The indirect signs had no significant statistic difference between the acute and chronic PE (P＞ 0.05) . Conclusion DSCTPA is helpful in the characterization of acute and chronic PE according to direct signs, and has certain guiding significance for clinical treatment.
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