256层螺旋ct肺动脉造影对肺动脉栓塞的诊断价值

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1、256层螺旋CT肺动脉造影对肺动脉栓塞的诊断价值【摘要】目的探讨256层螺旋CT肺动脉造影（CTPA）对肺动脉栓塞的诊断价值。方法回顾性分析50例经256层螺旋CTPA确诊的肺动脉栓塞患者的临床资料。结果50例肺动脉栓塞患者CTPA显示共累计720处肺动脉及分支。肺动脉栓塞的直接征象为肺动脉完全或部分重要缺损，分为中心型、附壁环型、偏心型及闭塞型。累及肺动脉情况：左肺动脉主干80处，右肺动脉主干69处，肺叶动脉198处，肺段动脉301处，亚段动脉72处。间接征象CT表现为局限性肺纹理疏松、肺密度减低4例；肺梗死灶形成3例，

2、表现为肺实质内边缘模糊的三角形实变影，基底位于胸膜，尖端指向肺门，部分表现为斑片状或大片状实变，增强扫描时这些梗死灶不被强化为特点；肺动脉高压2例，表现为中心肺动脉增宽，中心肺动脉与外围肺动脉不对称；右心室增大1例；胸腔积液5例。结论256层螺旋CT在临床应用中具有准确、快速、无创、图像清晰等优势，可直观、立体地显示肺动脉栓塞的大小、分布及范围，可成为检查肺动脉栓塞的首选方法，值得在临床推广应用。价值DOI：10.14163/j.cnki.ll-5547/r.2016.16.018【Abstract】ObjectiveTo

3、investigatediagnosticvalueby256-slicespiralCTpulmonaryangiography(CTPA)forpulmonaryarteryembolism.MethodsAretrospectiveanalysiswasmadeonclinicaldataof50pulmonaryarteryembolismpatients，whowerediagnosedby256-slicespiralCTPA.ResultsThereweretotally720pulmonaryarterie

4、sandbrancheswithCTPAcolorationin50pulmonaryarteryembolismpatients.Directsignsofpulmonaryarteryembolismincludedcompleteorpartialmajordefects，ascentertype，wall-attachedcirculartype，eccentrictypeandblocktype.Involvedpulmonaryarteriesincluded80leftpulmonaryarterialtru

5、nkcases，69rightpulmonaryarterialtrunkcases，198pulmonarylobearterycases，301pulmonarysegmentarterycasesand72subsegmentarterycases.IndirectsignswereshownbyCTas4caseswithlocalizedpulmonarytextureosteoporosisanddecreasedlungdensity；3caseswithpulmonaryinfarctionlesionse

6、xpressingobscuretrilateralconsolidationshadowsininwardpulmonaryparenchymaflangebasedonpleuraandpointinghiluspulmonis，partiallypatchyorbigconsolidationasnon-featureinenhancementscan；2caseswithpulmonaryhypertensionexpressingbroadeningandasymmetrycentralpulmonaryarte

7、ry；1casewithrightventricularenlargement；5caseswithpleuraleffusion.Conclusion256-slicespiralCTcontainsadvantagesofaccuracy，celerity，non-invasion,andimageclarityinclinicalapplication，anditcanvisuallyandstereoscopicallyshowsize，distributionandrangeofpulmonaryarteryem

8、bolism.Thismethodcanbetakenasthepreferredmethodinexaminingpulmonaryarteryembolism，anditisworthclinicalpromotionandapplication.【Keywords】256-slicespiralC