螺旋CT肺动脉造影对急性肺血栓栓塞症的诊断价值

摘要

目的 评估螺旋CT肺动脉造影(SCTPA)在急性肺血栓栓塞症诊断的作用.方法 回顾性分析43例急性肺栓塞患者螺旋CT 肺动脉造影结果.结果 43例患者795支肺动脉分支中254支发生栓塞(32 %),直接征象:部分性充盈缺损152 处(60 %) 、完全性阻塞76 处(30 %) 、轨道征8 处(3 %) 、附壁血栓6 处(2 %) ,灌注减低并密度不均12 处(5% );间接征象:肺动脉扩张13例(30 %) 、栓塞近端肺小动脉异常增粗6例(14 %) 、局部肺纹理稀疏、纤细22例(51 %) 、马赛克征3例(7 %) 、胸腔积液7例(16 %) 、肺不张7例(16 %) 、肺楔形变4例(9 %) 、磨玻璃影6例(14 %) .结论 SCTPA是诊断急性肺血栓栓塞症准确、简便、无创伤的有效方法.%Objective To evaluate the diagnostic value of Spiral CT pulmonary angiography (SCTPA) in acute pulmonary thromboembolism. Methods Retrospective analysis of SCTPA changes in 43 patients with acute pulmonary embolism. Results An embolism was found in254 of795 pulmonary arteries in 43 cases (32 %) . Direct signs included partial filling defect (60 %) , complete occlusion (30 %), railway-track sign (3 %) , mural filling defect (2 %) ,low perfusion and varied lung density (5%). Indirect signs included pulmonary artery dilatation in 13 cases(30 %) , focal fine pulmonary blood vessels 22 (51 %) , mosaic sign 3 (7 %) , effusion 7 (16 %) , atelectasis 7(16 %) , cuniform change 4(9 %) , ground glass shadow 6 (14%). Conclusion SCTPA is an effective method for the diagnosis of acute pulmonary thromboembolism, which is accurate , easy to perform and noninvasive.