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医学论文范文:64排螺旋CT血管造影对肺动脉栓塞的诊断价值
【摘要】 目的 评价64排螺旋CT肺动脉血管造影(CT pulmonary angiography, CTPA)对肺动脉栓塞(pulmonary embolism, PE)的诊断价值。方法 对临床疑诊急性肺动脉栓塞的72例患者行CTPA检查，并行多平面重建(MPR)，最大密度投影(MIP)及容积重建技术(VR)。结果 72例共累及476处肺动脉及分支，其中右肺动脉主干36处，左肺动脉主干42处，肺叶动脉157处，肺段动脉203处，亚段动脉38处， CTPA征象分为直接和间接征象，直接征象：肺动脉主干或分支内混合性、附壁性、中心性充盈缺损。间接征象：局限性肺纹理稀疏，肺动脉高压，右心室增大，胸腔积液等。结论 64排CTPA具有准确、快速、无创伤等优点，可立体、直观地观察到肺动脉血栓的大小、分布及范围并可观察肺内间接改变，是临床诊断及观察疗效的首选方法。
【关键词】 肺动脉栓塞;血管造影术;64排螺旋CT
The value of 64 multidetector helical CT angiography
in diagnosis of pulmonary embolismKANG Jingxia
(Dept. of Radiology, Lin Yi People's Hospital, Linyi 276003, China)
Abstract:Objective: To evaluate the value of 64 multidetector helical computer tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism (PE). Methods: Seventy-two patients clinically suspected of PE underwent 64 multidetector CTPA. MPR, MIP and VR were performed simultaneously. Results: The embolisms were found to be involved in 476 branches of the pulmonary arteries in all 72 cases with PE, including involved right main pulmonary artery 36 branches, left main pulmonary artery 42 branches, lobular pulmonary artery 157 branches, segmental pulmonary artery 203 branches and subsegmental pulmonary artery 38 branches. The CT features of PE cases included the direct signs: mixed filling defect, mural filling defect, central filling defect; and the indirect signs: local oligemia, pulmonary hypertension, enlargement of right ventricle, and pleural effusion, etl. Conclusion: Sixty-four multidetector CTPA is an accurate, quick and noninvasive method in the diagnosis of PE, which can be used widely. It can help us to observe the size, distribution and area of the embolism. In a word, it is an optimal method for the clinical diagnosis and observation.
Key words:pulmonary embolism; angiography; 64 multidetector helical CT
肺动脉栓塞(PE)又称肺栓塞，是指内源性或外源性栓子栓塞肺动脉，引起肺循环和呼吸功能障碍为主要表现的一组复杂的临床综合征，该病死亡率高达20%～30%，而及时诊断和治疗可使病死率下降为3%～10%[1]，所以PE的早期诊断和及时治疗至关重要。64排螺旋CT因其亚秒的扫描速度，高度的空间、时间分辨率而使CT血管成像技术能清晰显示肺血管及分支的解剖细节。本研究回顾性分析了72例PE病人的64排CT血管造影资料，评价其临床应用价值医学全.在线www.med126.com。
1 资料与方法
1.1 一般资料 本组72例均为我院2005年12月至2007年8月间临床高度疑诊为肺栓塞的患者中确诊者，其中男45例，女27例，年龄19～65岁，平均年龄42岁，其中52例有明显下肢静脉血栓史，6例有外伤史，12例有风湿性心脏病史，2例有分娩史。主要临床表现为胸痛、胸闷、气短、咯血、呼吸困难等。
