急性肺动脉栓塞的CT肺动脉造影和MR诊断的对比研究

摘要

目的：探讨急性肺动脉栓塞（PE）的多层螺旋CT肺动脉造影（MSCTPA）和MR肺动脉成像（MRPA）的诊断价值并进行对比。方法：选取2012年9月-2013年10月本院收治并拟诊为PE的患者52例，根据患者采用的成像方法分为CT组（n=41）和MR组（n=11），CT组患者行MSCTPA，MR组患者行1.5T MRPA，均观察肺动脉栓子的特点和肺叶继发变化情况，并由2位不知情的高级职称影像科医师对两组图像进行分析，统计不同部位的急性肺动脉栓塞检出数量。结果：CT组患者中，MSCTPA共发现肺动脉栓子661支，包括488支中段以上栓子。MR组患者中，MRPA共发现31支肺动脉栓塞。结论：MSCTPA操作简单，快捷，可清楚地显示肺动脉栓子，检出率高；MRPA可清楚显示肺叶动脉以上的栓子，但肺段动脉栓子仅部分可显示清楚，可结合三维增强磁共振动脉成像（3D-CE-MRPA）进行诊断。%Objective:To discuss and compare the diagnostic value for acute pulmonary embolism(PE)of multi-slice spiral CT pulmonary angiography(MSCTPA)and MR pulmonary angiography(MRPA).Method:52 cases of PE patients from September 2012 to October 2013 in our hospital were selected and divided into the CT group and the MR group according to the pulmonary angiography method.Patients on the CT group(n=41)were diagnosed MSCTPA, patients on the MR group(n=11)were diagnosed with1.5T MRPA.The characteristics of pulmonary emboli and pulmonary lobe secondary changes were observed.The pulmonary angiography pictures of both group were evaluated and analysed by two senior title image doctors who did not know this study,The embolus of different parts acute pulmonary embolism were recorded.Result:MSCTPA showed 661 pulmonary embolus,and 488 emboli branch in the above pulmonary section. MRPA showed 31 embolism of pulmonary artery branch.Conclusion:MSCTPA is a simple,quick pulmonary angiography method,and can clearly display the pulmonary embolus with a high detection rate.MRPA can clearly display the lobar artery above the embolus,but the segmental arterial embolus can not be displayed clearly.Combination with three-dimensional contrast-enhanced magnetic resonance angiography(3D-CE-MRPA)for diagnosis is necessary.