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目的探讨肺动脉栓塞(pu lmonary embolism,PE)的多层螺旋CT(MSCT)表现特征,评价MSCT对PE的诊断价值。方法回顾分析43例临床诊断PE患者的16层螺旋CT肺动脉造影资料的影像学表现,并与其肺动脉造影(DSPA)或随访结果相对照。结果本组43例均与临床诊断相符,中心型16例,周围型23例,混合型4例。多层螺旋CT肺动脉造影(MSCTPA)对叶及叶以上肺动脉的显示率达100%,检出PE阳性20支,段肺动脉清楚显示726支(显示率达84.4%),检出PE阳性109支,亚段肺动脉清楚显示1185支(显示率达68.9%),检出PE阳性61支。PE的直接征象包括血管腔完全闭塞、部分充盈缺损、轨道征和附壁血栓;间接征象有肺梗死灶、“马赛克”征、右室增大和/或肺动脉扩张、胸腔积液、心包积液等。结论MSCTPA诊断PE简便、安全、无创,对亚段肺动脉栓塞的诊断准确、可靠,是诊断早期肺动脉栓塞的首选方法。
Objective To investigate the multi-slice spiral CT (MSCT) features of pulmonary embolism (PE) and evaluate the value of MSCT in the diagnosis of PE. Methods A retrospective analysis of 43 cases of clinically diagnosed PE patients with 16-slice spiral CT pulmonary angiography imaging performance, and with its pulmonary arteriography (DSPA) or follow-up results were compared. Results The group of 43 cases were consistent with clinical diagnosis, 16 cases of central type, 23 cases of peripheral type, 4 cases of mixed type. MSTPA showed 100% of the pulmonary arteries above the leaf and leaf, 20 PE positives, 726 pulmonary arteries clearly (84.4%), 109 positive PE, Sub-paragraph pulmonary artery clearly shows 1185 (display rate of 68.9%), detected 61 PE positive. Direct signs of PE include complete obliteration of the lumen, partial filling defect, orbital signs and mural thrombus; indirect signs of pulmonary infarction, “mosaic” sign, right ventricular enlargement and / or pulmonary dilatation, pleural effusion, pericardial effusion . Conclusion The diagnosis of PE by MSCTPA is simple, safe and noninvasive. It is accurate and reliable for the diagnosis of pulmonary embolism in the sub-region. It is the first choice for the diagnosis of early pulmonary embolism.