双能CT肺灌注成像评价肺栓塞栓子形态与功能改变的相关性研究

发布时间：2018-06-07 14:40

本文选题：双能量体层摄影术 + 肺动脉栓塞　；参考：《中国现代医学杂志》2017年17期

【摘要】：目的采用双源计算机体层摄影(DSCT)双能量肺灌注成像诊断肺动脉栓塞(PE),探讨栓塞部位及形态与双能量肺灌注的相关性。方法收集临床怀疑PE,行DSCT双能量肺灌注成像患者120例。(1)分析PE部位及分型;(2)分析PE部位及分型与双能量肺灌注灌注缺损类型的比较;(3)分析纵隔窗肺动脉增强图像与肺灌注图像诊断PE的吻合性,以及肺灌注图像与肺窗图像诊断PE肺内灌注改变的吻合性。结果 (1)从PE发生部位分析,右侧PE的比例高于左侧肺动脉,肺叶动脉较左、右肺动脉干多,双下肺动脉较双上肺动脉多;从形态上分析,以中心型和完全闭塞型居多,附壁型次之,不规则型及马鞍型较少;(2)在不同类型的肺动脉干PE中,完全型易发生于全肺或肺叶灌注缺损,附壁型或中心型常出现肺叶或段灌注缺损;若PE发生在肺叶或肺段,则完全型多出现肺叶或段灌注缺损,而附壁型或中心型多出现肺段或亚段灌注缺损或无灌注缺损;若PE发生在亚段,则多见亚段灌注缺损或无灌注缺损;(3)纵隔窗肺动脉增强图像与肺灌注图像诊断PE的吻合性好,肺灌注图像与肺窗图像诊断PE肺内灌注改变的吻合性差。结论肺灌注成像与PE部位及形态具有一定的相关性,DSCT双能量肺灌注成像能协助诊断PE。
[Abstract]:Objective to diagnose pulmonary embolism (PE) by dual source computed tomography (DSCT) dual energy pulmonary perfusion imaging (DSCT), and to investigate the correlation between the location and morphology of embolism and double energy pulmonary perfusion. Methods A total of 120 cases (120 cases) of DSCT double energy pulmonary perfusion imaging with suspected PE2 were collected. The location and type of PE were analyzed and compared with the type of double energy pulmonary perfusion defect. 3) the contrast of pulmonary artery enhancement images of mediastinal window and pulmonary artery was analyzed. Coincidence with pulmonary perfusion images in diagnosis of PE. The coincidence of pulmonary perfusion images with pulmonary window images in the diagnosis of pulmonary perfusion changes in PE. Results 1) the proportion of PE in the right side was higher than that in the left pulmonary artery, the right pulmonary artery was more than the left, the right pulmonary artery was more than the right pulmonary artery, and the bilateral inferior pulmonary artery was more than the bilateral superior pulmonary artery. In different types of pulmonary trunk PE, the complete type is more likely to occur in the whole lung or the pulmonary lobe perfusion defect, the wall attached type or the central type often has the pulmonary lobe or segment perfusion defect; if the PE occurs in the lung lobe or the lung segment, the wall type or the central type often appears the lung lobe or the segmental perfusion defect; if the PE occurs in the lung lobe or the lung segment, If PE occurs in the subsegment, the pulmonary lobe or segmental perfusion defect is more common in the complete type than in the wall attached type or central type, and there is no perfusion defect in the lung segment or subsegment. if PE occurs in the subsegment, Subsegmental perfusion defect or no perfusion defect was more common (P < 0.05). Pulmonary artery enhancement images of mediastinal window and pulmonary perfusion images had good coincidence with pulmonary perfusion images in the diagnosis of PE, and pulmonary perfusion images and pulmonary window images had poor coincidence in the diagnosis of pulmonary perfusion changes of PE. Conclusion Pulmonary perfusion imaging has a certain correlation with the location and morphology of PE. DSCT dual energy pulmonary perfusion imaging can help in the diagnosis of Pe.
【作者单位】：云南省第三人民医院放射医学影像科;
【分类号】：R563.5;R816.41

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