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醫(yī)學論文范文:64排螺旋CT血管造影對肺動脈栓塞的診斷價值
【摘要】 目的 評價64排螺旋CT肺動脈血管造影(CT pulmonary angiography, CTPA)對肺動脈栓塞(pulmonary embolism, PE)的診斷價值。方法 對臨床疑診急性肺動脈栓塞的72例患者行CTPA檢查，并行多平面重建(MPR)，最大密度投影(MIP)及容積重建技術(shù)(VR)。結(jié)果 72例共累及476處肺動脈及分支，其中右肺動脈主干36處，左肺動脈主干42處，肺葉動脈157處，肺段動脈203處，亞段動脈38處， CTPA征象分為直接和間接征象，直接征象：肺動脈主干或分支內(nèi)混合性、附壁性、中心性充盈缺損。間接征象：局限性肺紋理稀疏，肺動脈高壓，右心室增大，胸腔積液等。結(jié)論 64排CTPA具有準確、快速、無創(chuàng)傷等優(yōu)點，可立體、直觀地觀察到肺動脈血栓的大小、分布及范圍并可觀察肺內(nèi)間接改變，是臨床診斷及觀察療效的首選方法。
【關(guān)鍵詞】 肺動脈栓塞;血管造影術(shù);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
肺動脈栓塞(PE)又稱肺栓塞，是指內(nèi)源性或外源性栓子栓塞肺動脈，引起肺循環(huán)和呼吸功能障礙為主要表現(xiàn)的一組復雜的臨床綜合征，該病死亡率高達20%～30%，而及時診斷和治療可使病死率下降為3%～10%[1]，所以PE的早期診斷和及時治療至關(guān)重要。64排螺旋CT因其亞秒的掃描速度，高度的空間、時間分辨率而使CT血管成像技術(shù)能清晰顯示肺血管及分支的解剖細節(jié)。本研究回顧性分析了72例PE病人的64排CT血管造影資料，評價其臨床應用價值醫(yī)學全.在線gydjdsj.org.cn。
1 資料與方法
1.1 一般資料 本組72例均為我院2005年12月至2007年8月間臨床高度疑診為肺栓塞的患者中確診者，其中男45例，女27例，年齡19～65歲，平均年齡42歲，其中52例有明顯下肢靜脈血栓史，6例有外傷史，12例有風濕性心臟病史，2例有分娩史。主要臨床表現(xiàn)為胸痛、胸悶、氣短、咯血、呼吸困難等。
