多层螺旋ct对脓毒性肺栓塞滋养血管征的评价

《多层螺旋ct对脓毒性肺栓塞滋养血管征的评价》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、多层螺旋CT对脓毒性肺栓塞滋养血管征的评价韦建林郭兴李炳灿莫婧（广西医科大学第四附属医院放射科广西柳州545005）摘要目的运用多层螺旋CT研究评价肺血管与脓毒性肺栓塞滋养血管征之间关系。材料与方法采用双盲法由两名观察者回顾性分析11例SPE与10例病理证实癌症的肺转移病人MDCT图像，通过横断面、MPR（多维平面重建）、MIP（最大密度投影）分析肺结节与肺血管关系，滋养血管征定义为一支血管直接伸入结节。结果SPE病人发现91个结节和32个楔形阴影。其中横断位图像显示36（40%）个结节和8（25%）个楔形阴影有血管进入结节，而在MPR（未静脉对比增强）和MIP（静

2、脉对比增强）显示这些血管绕行结节周围。在所有的成像中，14(15%）个结节和4(13%)个楔形阴影显示血管进入病灶。在横断位像所有这些血管汇入左心房与肺静脉征象一致；在肺转移病人也发现相似征象。结论脓毒性肺栓塞在横断位图像经常能显示滋养血管，但是MPR能显示大多数滋养血管环绕结节走行，其中有些为肺静脉。关键词脓毒性肺栓塞，多层螺旋CTMDCTforevaluationofthefeedingvesselsigninsepticpulmonaryembolism（WeiJianlin，GuoXing，LIBingcan，etal.RadiologyDepartment

3、，theFourthAffiliatedHospitalofGuangxiMedicalUniversity，Liuzhou，Guangxi545005，China）[Abstract]Objective.TheobjectiveofthisstudywastouseMDCTtoassesstherelationofthepulmonaryvasculaturetosepticpulmonaryembolismwithparticularattentiontothefeedingvesselsign.MATERIALSANDMETHODS.TheMDCTscanso

4、f11patientswithsepticemboliwereretrospectively,blindlyevaluatedbytwoobservers.Acontrolgroupof10patientswithdocumentedpulmonarymetastasisandpathologicallyprovencarcinomaalsowereincluded.Transverseimages,multiplanarreconstructions,andmaximumintensityprojectionswereusedtoanalyzenodulesand

5、thepulmonaryvasculature.Thefeedingvesselsignwasdefinedasavesselcoursingdirectlyintoanodule.RESULTS.Thepatientswithpulmonarysepticembolismhadatotalof91nodulesand32wedge-shapedopacities.Transverseimagesshowedthat36(40%)ofthenodulesand8(25%)ofthewedge-shapedopacitieshadavesselthatappeared

6、toenterthenodule,butmultiplanarreconstructions(withoutIVcontrastenhancement)andmaximumintensityprojections(withIVcontrastenhancement)showedthevesselspassedaroundthenodules.Fourteen(15%)ofthesphericalnodulesandfour(13%)ofthewedge-shapedopacitiesexhibitedacentralvesselenteringthelesionin

7、allimagingplanes.Allofthesevesselsweretracedtotheleftatriumontransverseimages,afindingconsistentwithpulmonaryveinbranches.Similarfindingswereseeninpulmonarymetastaticlesions.CONCLUSION.Althoughsepticpulmonaryembolismoftenappeartohaveafeedingvesselonconventionalcross-sectionalimages,m