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目的:探讨多层螺旋CT肺动脉造影(MSCTPA)对肺动脉栓塞(PE)的诊断及应用价值。方法:用16层及64层螺旋CT对临床疑似肺栓塞的196例病人行MSCTPA检查,采用横断面图像结合多平面重建、容积再现、最大密度投影等多种图像后处理技术综合分析进行诊断结果:196例病人1～5级肺动脉显示率分别为100.00%、100.00%、100.00%、99.67%、98.00%PE组中,对16层与64层的5级肺动脉显示率进行比较,x~2=27.29,P<0.05,差异有统计学意义;非PE组,对16层与64层的5级肺动脉显示率进行比较,x~2=3.44,P>0.05,差异无统计学意义;采用16层CT,对有、无PE组的5级肺动脉显示率进行比较,x~2=3.50,P>0.05,差异无统计学意义;采用64层CT,对有、无PE组的5级肺动脉显示率进行比较,x~2=1.38,P>0.05,差异无统计学意义。肺动脉栓塞直接征象为肺动脉管腔内充盈缺损,间接征象包括肺动脉高压、胸腔积液及肺梗死等,其各自的发生率分别为50.62%、33.33%、41.97%。结论:MSCTPA是一种无创性的血管成像方法,能够安全、快捷、准确显示肺动脉栓塞,可作为目前PE最主要的影像学检查方法。
Objective: To investigate the diagnostic value of multislice spiral CT pulmonary angiography (MSCTPA) for pulmonary embolism (PE). Methods: Sixty-six patients with suspected pulmonary embolism underwent 16-slice and 64-slice spiral CT. MSCTPA was used to examine the results of the diagnosis by multi-planar reconstruction, volume rendering and maximum density projection. The detection rates of grade 5 pulmonary arteries in 16 patients and 64 patients in the 196 PE patients were 100.00%, 100.00%, 100.00%, 99.67% and 98.00% 27.29, P <0.05, the difference was statistically significant. In non-PE group, the display rate of grade 5 pulmonary artery in 16th and 64th layer was compared with x ~ 2 = 3.44, P> 0.05. There was no significant difference in grade 5 pulmonary arteries with or without PE between two groups (x ~ 2 = 3.50, P> 0.05). The level of grade 5 pulmonary arteries For comparison, x ~ 2 = 1.38, P> 0.05, the difference was not statistically significant. Pulmonary embolism is a direct sign of pulmonary artery filling cavity defect, indirect signs of pulmonary hypertension, pleural effusion and pulmonary infarction, the respective incidence rates were 50.62%, 33.33%, 41.97%. Conclusion: MSCTPA is a noninvasive method of angiography, which can display pulmonary artery embolism safely, rapidly and accurately. It can be used as the most important imaging examination method of PE at present.