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目的评价16层螺旋CT诊断肺栓塞(pulmonary embolism,PE)特别是周围型肺栓塞的价值。方法9只犬于DSA下经导管将直径2~4mm、长1cm左右的明胶海绵条及直径为1mm、长1cm的线段若干注入肺动脉,制成周围型肺栓塞动物模型,定期对实验犬行肺部CT扫描,观察肺梗死出现情况。10d后行多层螺旋CT肺血管造影(multi-slicespiral CT pulmonary angiography,MSCTPA)检查,检查后将实验犬处死并对肺组织行病理观察。结果9只犬全部完成实验过程,其中4只犬发生了肺梗死,MSCT-PA共发现了52支肺动脉栓塞,其中叶动脉2支,段动脉18支,亚段动脉32支。病理解剖发现55支肺动脉栓塞,其中叶动脉2支,段动脉18支,亚段动脉35支。诊断周围型肺栓塞的准确性为94.34%,对发生在亚段肺动脉内的肺栓塞准确性为91.43%,阳性预测价值为94.12%。结论16层螺旋CT是诊断肺栓塞的可靠方法。
Objective To evaluate the value of 16-slice spiral CT in the diagnosis of pulmonary embolism (PE), especially peripheral pulmonary embolism. Methods Nine dogs were implanted with DSA gelatin sponge 2 ~ 4mm in diameter and 1cm in length with a diameter of 1mm and a length of 1cm into the pulmonary artery to make a peripheral pulmonary embolism animal model. Department CT scan to observe the occurrence of pulmonary infarction. After 10 days, multi-slice CT pulmonary angiography (MSCTPA) examination was performed. After the test, the dogs were sacrificed and pathological observation of lung tissue was performed. Results Nine dogs completed the experiment. Pulmonary infarction occurred in four dogs. MSCT-PA found a total of 52 pulmonary embolisms, including 2 arteries, 18 arteries and 32 arteries. Pathological anatomy found 55 pulmonary embolism, including two in the leaf arteries, 18 arteries, 35 arteries sub-segment. The diagnostic accuracy of peripheral pulmonary embolism was 94.34%, the accuracy of pulmonary embolism in sub-pulmonary artery was 91.43%, and the positive predictive value was 94.12%. Conclusion 16-slice spiral CT is a reliable method to diagnose pulmonary embolism.