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目的 :分析多层螺旋CT(multislicespiralCT ,MSCT)对肺动脉栓塞的肺血管分布及肺内改变的诊断价值。方法 :回顾分析 12例肺动脉栓塞患者的增强MSCT图像。将受累肺动脉分为中央型、周围型、混合型 ;肺叶水平动脉内充盈缺损分为完全型、部分充缺 ,并观察对比相应区域肺内改变。结果 :肺动脉栓塞周围型 2例 ,混合型 10例 ;受累肺叶动脉 2 5支 ,9支完全充盈缺损 ,16支部分充缺。随就诊检查时间的延长 ,部分充缺的比例有所增大。 12例中肺内出现实变 3例 ,出现频率为 2 5 % ,其中 1例诊断为肺炎 ,胸腔积液 4例。结论 :MSCT可以明确诊断肺动脉栓塞 ,多平面重建有助于其确诊。肺动脉栓塞的肺内改变发生率不高且无特异性 ,要以观察到栓塞的肺血管分布区一致为依据 ,肺内阴影的定性应结合临床及追随观察。
Objective: To analyze the value of multi-slice spiral CT (multislicespiral CT, MSCT) in the diagnosis of pulmonary vascular distribution and pulmonary changes in pulmonary embolism. Methods: The enhanced MSCT images of 12 patients with pulmonary embolism were retrospectively analyzed. Pulmonary arteries will be divided into central type, peripheral type, mixed type; pulmonary artery filling the defect level is divided into complete, partial insufficiency, and observed and compared the corresponding regional lung changes. Results: There were 2 peripheral pulmonary embolism cases and 10 mixed cases. Twenty - five lung lobular arteries were involved, 9 were completely filled with defects and 16 were partially deficient. With the extension of the examination time, the proportion of partial deficiency has increased. In 12 cases, 3 cases appeared consolidation in the lung, with a frequency of 25%. One case was diagnosed as pneumonia and 4 cases of pleural effusion. Conclusion: MSCT can clearly diagnose pulmonary embolism, and multiplanar reconstruction can help confirm its diagnosis. The incidence of pulmonary embolism changes in the lung is not high and non-specific, to be consistent with the observed pulmonary vascular distribution of embolism, the qualitative lung shadow should be combined with clinical and follow-up observation.