Value of Dual-soure CT in Diagnosing Pulmonary Artery Embolism_West China Medical Journal

Authors：

SHI Bingyan ¹ ,  WU Dan ² , PENG Liqing ³ , HUNAG Yunfeng ⁴ , XIAN Dengqin ⁴

1. Sanitary Corps of Chengdu Branch of Sichuan Provincial Corps Hospital, Chinese People′s Armed Police Forces, Chengdu, Sichuan 610000, P. R. China; 2. Department of Nephrology, 3. Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 4. Chengdu Hospital of Sichuan Provincial Corps Hospital, Chinese People′s Armed Police Forces, Chengdu, Sichuan 610000, P. R. China;

Corresponding?author：

WU Dan, Email: sbychina@163.com

Keywords：

肺栓塞; X線計算機; 血管造影術

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【摘要】　目的　探討雙源CT在診斷肺栓塞中的價值。　方法　 2008年5月－2010年12月納入50例可疑肺栓塞患者，使用雙源CT進行肺動脈血管增強掃描，對圖像行三維重建，分析栓塞部位、栓子形態、肺內、心臟及胸腔改變等。　結果　 44例確診肺栓塞，發現肺栓塞共260處，最常見于右肺下葉動脈28例（63.0%），其次于右肺動脈22例（50.0%）、左肺下葉動脈19例（43.2%）；15例（34.1%）累及亞段肺動脈；右肺動脈受累較左肺動脈常見（P lt;0.05）。39例系急性肺栓塞（88.6%），5例系慢性肺栓塞（11.4%）。　結論　雙源CT掃描速度快，空間分辨率高，可以準確顯示肺栓塞部位，并且可以同時評價胸腔、肺內及心臟的變化。在臨床上，雙源CT可以作為肺栓塞的首選檢查。
【Abstract】　Objective　 To explore the value of dual-source CT in diagnosing pulmonary embolism.　Methods　 From May 2008 to December 2010, 50 patients who were suspected of pulmonary embolism were included, and pulmonary angiography was performed on these patients by dual-source CT. The obtained images were reconstructed with three dimensional technique to analyze the location and shape of the embolism, and lesions affecting the lung, heart and thoracic cavity.　Results　 A total of 44 patients wiht pulmonary embolism with 260 affected branches of arteries were confirmed by CT angiography. The most common affecting artery was the right lower pulmonary artery(28/44,63.0%), which was followed by the right pulmonary artery (22/44,50.0%) and the left lower pulmonary artery(19/44,43.2%). Segmental and subsegmental pulmonary arteries were involved in 15 patients (15/44, 34.1%). Pulmonary artery embolism involves the right pulmonary arteries more frequently than the left pulmonary arteries (P＜0.05).Acute pulmonary embolism was found in 39 cases(39/44, 88.6%), while chronic pulmonary embolism was found in 5(5/44, 11.4%).　Conclusions　 Dual-source CT with fast scanning speed and high spatial resolution can demonstrate the exact site of the pulmonary embolism and evaluate the lesions of thoracic cavity, lung and heart. In clinical practice, dual-source CT could be the preferred choice in diagnosing pulmonary embolism.

Citation： SHI Bingyan,WU Dan,PENG Liqing,HUNAG Yunfeng,XIAN Dengqin. Value of Dual-soure CT in Diagnosing Pulmonary Artery Embolism. West China Medical Journal, 2011, 26(7): 1068-1071. doi: Copy

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11.	李永寶, 靳激揚, 鄭力. 肺動脈栓塞的多層螺旋CT診斷價值[J]. 中華腫瘤防治雜志, 2010, (23): 1970-1971.
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1. 　Drucker EA, Rivitz SM, Shepard JA, et al. Acute pulmonary embolism: assessment of helical CT for diagnosis[J]. Radiology, 1998, 209 (3): 235-241.
2. 　Garg K, Welsh CH, Fyerabend AJ, et al. Pulmonary embolism: diagnogsis with spiral CT and ventilation perfusion scanning correlation with pulmonary angiographic results or clinical outcome[J]. Radiology, 1998, 208(3): 201-208.
3. 　尹長山, 齊星亮, 于春祥, 等. 多層螺旋CT在肺動脈栓塞診斷中的應用(附27例報告) [J]. 放射學實, 2007, 22(5): 468-470.
4. 　潘紅日. 多層螺旋CT及其圖像后處理技術診斷肺栓塞的價值[J]. 國際醫學放射學雜, 2010, 33(4): 345-347.
5. 　馮凱琳, 付維林, 李祖貴, 等. 多層螺旋CT對肺動脈栓塞的診斷價值[J]. 武警醫學院學報, 2007, 16(7): 235-238.
6. 　戴自英. 實用內科 [M]. 北京: 人民衛生出版社, 1994: 885-887.
7. 　黨奇, 李嘉姝. 多層螺旋CT 診斷急性肺栓塞的臨床價值[J]. 中國實用內科雜志, 2010, 30(9): 833-834.
8. 　王樂民. 肺栓塞臨床類型及實驗檢查[J]. 中國循環雜志, 1998, 13(4): 193.
9. 　Contractor S, Maldjian PD, Sharma VK, et al. Role of helical CT in detecting right ventricular dysfunction secondary to acute pulmonary embolism[J]. J Comput Assist Tomogr, 2002, 26(4): 587-591.
10. 　Lu MT, Cai T, Ersoy H, et al. Comparison of ECG-gated versus non-gated CT ventricular measurements in thirty patients with acute pulmonary embolism[J]. Int J Cardiovas Imag, 2009, 25(1): 101-107.
11. 　李永寶, 靳激揚, 鄭力. 肺動脈栓塞的多層螺旋CT診斷價值[J]. 中華腫瘤防治雜志, 2010, (23): 1970-1971.
12. 　Riedel M. Diagnosing pulmonary embolism[J]. Postgrad Med J, 2004, 80(944): 309-319.

West China Medical Journal

Value of Dual-soure CT in Diagnosing Pulmonary Artery Embolism

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