彩色多普勒超声与MSCT在诊断肺血栓栓塞-深静脉血栓中的价值分析

摘要

Objective:To explore the clinical value of color Doppler ultrasound and multi-slice spiral computed tomography (MSCT) in the diagnosis of pulmonary thromboembolism (PTE)- deep vein thrombosis (DVT).Methods: A retrospectively study was adopted to analyze 30 patients with suspected PTE-DVT. The patients with suspected PTE were applied by using MSCT and series three-dimensional reconstructions, such as volume reconstruction (VR), multi planar reconstruction (MPR), maximum intensity projection (MIP) and axial image reconstruction, while the patients with suspected DVT were scanned by using color Doppler flow imaging (CDFI). The shape, size and location of embolus in blood vessel were observed, and the situations of pulmonary artery embolism and the phenomenon of deep vein embolism detected by the two methods were compared and analyzed.Results: In 30 cases, there were 15 cases were diagnosed as positive patients, and in the 15 cases, the patients with DVT were 66.7% (10/15), while the patients with PTE were 86.7% (13/15), and the patients with PTE-DVT were 8 cases (53.3%, 8/15). By using MSCT, there were 10 patients with thromboembolism in pulmonary artery were found, and there were 50 pulmonary arteries with thromboembolism were diagnosed. On the other hand, by using color Doppler ultrasound, there were 12 patients with embolism and fluctuation disappearing of vein wall in deep vein were found, and there were 16 deep veins with thromboembolism were diagnosed.Conclusion: Color Doppler ultrasound should combine with MSCT and they should learn each other so as to achieve the diagnosis of PTE-DVT in convenient, fast, simple, safety and accuracy. This combination of them can provide important reference for clinical therapy of PTE-DVT.%目的:探讨彩色多普勒超声与多层螺旋CT(MSCT)在诊断肺血栓栓塞-深静脉血栓(PTE-DVT)症中的临床价值.方法:选取医院收治的30例疑似PTE-DVT患者资料进行回顾性分析;对PTE患者行MSCT以及容积重建(VR)、多平面重建(MPR)、最大密度投影(MIP)及轴位图像等三维重建;对DVT患者行彩色多普勒血流成像(CDFI)检查;观察患者血管内栓子的形态、大小及位置,分析两种方法检查出的肺动脉栓塞状况和深静脉栓塞征象.结果:30例患者诊断出阳性患者15例,其中DVT占66.7%(10/15),PTE占86.7%(13/15),诊断为PTE-DVT的患者8例,占53.3%(8/15).MSCT检查发现肺动脉发生血栓栓塞情况的患者有10例,共诊断出发生血栓栓塞的肺动脉有50支;CDFI检查发现深静脉发生栓塞情况以及静脉壁波动消失的患者有12例,共诊断出发生血栓栓塞的深静脉有16支.结论:彩色多普勒超声与MSCT两种影像学检查方法互相结合、借鉴,方能更加快捷、简便、安全和准确地在临床中诊断出PTE-DVT,为临床治疗PTE-DVT提供重要依据.