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目的:研究多排螺旋CT肺血管造影(CTPA)在肺动脉栓塞(PE)诊断中的应用价值。方法:收集31例PE患者CTPA成像资料,运用多平面重建(MPR)、最大密度投影(MIP)、容积再现(VR)多种图像后处理技术,并结合轴位图像、注重扫描细节进行综合分析。结果:31例均可显示PE的部位、范围及局部管腔狭窄程度。PE的CT直接征象为中心型充盈缺损、偏心型充盈缺损、内缘隆起部分充盈缺损、附壁充盈缺损、完全充盈缺损;间接征象为肺血管分布不均、肺纹理稀疏、肺梗死,主肺动脉及左右肺动脉增宽、右心房室增大等肺动脉高压征象及心包积液、胸腔积液等。结论:CTPA诊断PE快捷、安全无创、敏感性高,选择适宜扫描参数及图像重建方法可清晰显示PE的部位及栓子的形态、范围等,及时指导临床诊治。
Objective: To investigate the value of multislice CT pulmonary angiography (CTPA) in the diagnosis of pulmonary embolism (PE). Methods: CTPA imaging data of 31 patients with PE were collected. Multiple post-processing techniques such as multiplanar reconstruction (MPR), maximum density projection (MIP) and volume rendering (VR) were used in combination with axial images and comprehensive scanning analysis . Results: All the 31 cases showed the location of PE, the extent of local stenosis. PE CT direct signs of central filling defect, eccentric filling defect, filling part of the inner rim of the defect, filling the defect defect, complete filling defect; indirect signs of pulmonary vascular uneven distribution of lung sparse lung infarction, the main pulmonary artery And left and right pulmonary enlargement, right atrial enlargement and other signs of pulmonary hypertension and pericardial effusion, pleural effusion and so on. Conclusions: CTPA diagnosis of PE fast, safe noninvasive, high sensitivity, select the appropriate scan parameters and image reconstruction method can clearly show the location of PE and emboli morphology, scope, timely guidance clinical diagnosis and treatment.