摘要
目的评价多层螺旋CT血管成像(MSCTA)诊断体-肺循环分流(BPS)的价值。方法回顾性分析31例DSA确诊的BPS的MSCTA资料,以超选择性支气管相关体动脉造影(DSA)为标准,对照分析MSCTA与DSA在诊断不同分流水平的BPS的一致性。结果 MSCTA显示肺动脉分支错期显影。在显示亚段以上的BPS的效能上与DSA相当(Z=-1.854,P>0.05),显示末梢BPS的效能明显低于DSA(Z=-3.923,P<0.05);MSCTA确诊BPS 11例,灵敏度为35.5%(11/31),检出的BPS肺动脉分支数、分流水平与DSA所见相当;检出的支气管相关异常体动脉数目与DSA相当;无假阳性病例。结论 MSCTA能够准确地诊断肺动脉亚段以上的大分流量BPS;显示异常的支气管相关体动脉,有助于介入术前对BPS程度及供血动脉的预计。
Objective To evaluate multi- slice spiral CT angiography （MSCTA） in diagnosing bronchial-pulmonary shunts （BPS）. Methods The materials of MSCTA images in 31 patients with DSA-confirmed BPS were retrospectively analyzed. Taking DSA imaging as the reference standard, the consistency in diagnosing BPS at different levels between MSCTA and DSA was compared. Results On MSCTA using aorta-density trigger scanning technique BPS was manifested as wrong-time enhancement of pulmonary artery branches. Wilcoxon test indicated that MSCTA had a high concordance with DSA in detecting BPS occurring at sub-segmental （or above） pulmonary artery branches （Z = -1.854, P 〉 0.05）, but MSCTA detection of BPS occurring at peripheral pulmonary arteries was obviously poorer than DSA （Z = -3.923, P 〈 0.05）. MSCTA confirmed the diagnosis of BPS in 11 cases with a sensitive rate of 35.5% （11/31）, and no differences in revealing the number and the shunt levels of BPS existed between DSA and MSCTA. The number of abnormal systemic arteries demonstrated by MSCTA was quite the same as the number detected by DSA. No false positive case was seen. Conclusion MSCTA is very effective in diagnosing high-flow BPS locating at sub-segmental （or above） pulmonary artery branches as well as in revealing abnormal bronchus-related systemic arteries, which is very helpful in preoperatively evaluating the severity of the BP shunting and the supplying arteries to be obstructed.
出处
《介入放射学杂志》
CSCD
北大核心
2014年第8期667-671,共5页
Journal of Interventional Radiology
基金
广东省科技计划项目(2010B031600114)
