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目的探讨64排螺旋CT在肺动脉栓塞诊断中的应用。方法回顾性分析郸城县人民医院2009年6月至2012年4月收治的26例肺动脉栓塞患者的临床资料,所有患者均行螺旋CT肺动脉造影检查,并将图像进行容积再现、最大密度投影及多平面重建后处理。结果 26例肺动脉栓塞病例共累及74支肺动脉或分支,CT直接征象为完全阻塞型3例,附壁型12例,中心型5例,附壁环型6例,间接征象为胸膜腔积液或心包积液5例(19.23%),肺动脉扩张或右心室增大共3例(11.54%),双肺斑片状渗出灶和实变影6例(23.07%)。结论 64排螺旋CT可清晰显示肺动脉栓塞的部位及栓子的形态,且具有快速、准确及无创伤等优势,可作为肺动脉栓塞临床诊断及疗效判定的首选方法。
Objective To explore the application of 64-slice spiral CT in the diagnosis of pulmonary embolism. Methods The clinical data of 26 patients with pulmonary embolism who were treated in Dancheng People ’s Hospital from June 2009 to April 2012 were retrospectively analyzed. All patients underwent spiral CT pulmonary angiography and volume rendering, maximum density projection Multi-plane reconstruction after processing. Results Totally 74 pulmonary arteries or branches were involved in 26 cases of pulmonary embolism. The direct signs of CT were totally obstructed in 3 cases, adherent wall in 12 cases, central coronoid in 5 cases and adherent wall ring in 6 cases. The indirect signs were pleural effusion or Pericardial effusion in 5 cases (19.23%), pulmonary artery dilatation or right ventricular enlargement in 3 cases (11.54%), double pulmonary patchy exudate lesions and real change in 6 cases (23.07%). Conclusion 64-slice spiral CT can clearly show the location of pulmonary embolism and the shape of emboli, and has the advantages of rapid, accurate and noninvasive. It can be used as the first choice for clinical diagnosis and curative effect evaluation of pulmonary embolism.