摘要
目的探讨基于CT血管造影(computer tomography pulmonary angiography,CTPA)的胸部高分辨率计算机体层X线摄影术(high-resolution computed tomography,HRCT)表现对肺栓塞的诊断价值。方法回顾性分析73例临床怀疑肺栓塞患者的CTPA及基于CTPA重建出的胸部HRCT图像,根据CTPA结果将所有病例分为肺栓塞组及非肺栓塞组,对比分析2组CTPA及胸部HRCT图像,归纳肺栓塞差异具有统计学意义的影像学征象。结果 CTPA确诊肺栓塞(阳性组)25例和排除肺栓塞(阴性组)48例,2组年龄和性别差异无统计学意义;左、右侧肺动脉栓塞支数差异无统计学意义;大部分栓子分布于肺段以下;中心性充盈缺损超过其他栓塞类型总和的2倍;肺栓塞组和非肺栓塞组最常见的胸部异常均为胸膜肥厚和实变影;HRCT肺动脉高压提示肺栓塞的可能性约为无肺动脉高压患者的3.29倍,肺动脉高压对于肺栓塞的发生具有预测价值。结论多排螺旋CT对于肺栓塞患者的检查,具有快捷无创、敏感性高的特点;在进行CTPA检查时,同时重建出肺部HRCT,可以实时评估肺部有无其他基础疾病,便于提高CTPA诊断价值,避免二次行胸部CT检查带来的额外辐射。
Objective To evaluate the diagnostic value of high-resolution computed tomography（HRCT）based on computer tomography pulmonary angiography（CTPA）in pulmonary embolism（PE）.Methods Retrospectively analyzed CTPA and the chest HRCT images based on the reconstruction of CTPA from 73 patients with suspected pulmonary embolism.According to the results of CTPA,all cases were divided into embolism group and non-embolism group.The CTPA and chest HRCT images between the two groups were compared.The radiographic sighs of pulmonary embolism with statistic significance were concluded.Results A total of 73 patients,diagnosed with PE in 25,ruled out of PE in 48.The two groups did not have any significant difference in the age,sex of the patients,and the number of the bronchi with embolism in left and right lung,respectively.The percentage of peripheral pulmonary embolism was much more than central pulmonary embolism.The central type embolism was two times more than the total of other types of embolism.Pleural thickening and consolidation signs were both highly common.HRCT pulmonary hypertension suggested the possibility of pulmonary embolism was about 3.29 times than that of the patients with pulmonary hypertension,pulmonary hypertension had predictive value for the occurrence of pulmonary embolism.Conclusion With the characteristics of quick,non-invasive and high sensitivity,reconstructed chest HRCT when taken CTPA at the same time,which could be used to assess in real time whether there were other basic disease of the lung in order to improve the value of CTPA diagnosis and avoid additional radiation caused by secondary chest CT examination.
出处
《河北医科大学学报》
CAS
2016年第2期175-178,182,F0003,共6页
Journal of Hebei Medical University
