64排螺旋CT对肺动脉血栓栓塞的临床应用价值

摘要

Objective: To investigate the diagnositic value of 64-slice spiral CT angiography (CTA) in pulmonary thromboembolism. Methods: 57 patients with clinically known PTE underwent pulmonary arterial CTA. The sourse image of all patients were postprocessed by multiple planar reformation (MPR), maximum intensity projection(MIP) and volume rendering (VR). Results: CTA showed clearly the location and range of emboli and stenosed lumens of PTF in all patients, Direct signs showed filling defects, such as central filling defects of 30 arteries. partial filling defects of 66 arteries and obstructive of 9 arteries; Indirect signs represented as the dilating of right ventrical and central pulmonary arteries, pleural effusion pericardial effusion, pulmonary infaction and so on. Conclusion: 64-slice spiral CT angiography is the first choice and non-invasive method for the dianosis of PTE.%目的:探讨64排螺旋CT血管造影对肺动脉血栓栓塞的诊断价值.方法:确诊为PTE的57例患者,均行肺动脉CTA检查,并对原始数据进行多平面重组(MPR)、最大密度投影(MIP)以及三维容积成像(VR)后处理.结果:57例患者CTA均显示肺栓塞的分布范围、栓塞部位及局部管腔狭窄程度,直接征象表现为肺动脉内充盈缺损,如中心性、偏心性或完全阻塞性;间接征象表现为肺动脉高压、中心肺动脉增宽、右心增大、胸腔积液、心包积液及肺梗死等.结论:64排螺旋CT血管造影是临床诊断肺动脉栓塞的无创性首选方法.