本文選題：雙能量體層攝影術(shù) + 肺動脈栓塞�。� 參考：《中國現(xiàn)代醫(yī)學雜志》2017年17期

【摘要】：目的采用雙源計算機體層攝影(DSCT)雙能量肺灌注成像診斷肺動脈栓塞(PE),探討栓塞部位及形態(tài)與雙能量肺灌注的相關(guān)性。方法收集臨床懷疑PE,行DSCT雙能量肺灌注成像患者120例。(1)分析PE部位及分型;(2)分析PE部位及分型與雙能量肺灌注灌注缺損類型的比較;(3)分析縱隔窗肺動脈增強圖像與肺灌注圖像診斷PE的吻合性,以及肺灌注圖像與肺窗圖像診斷PE肺內(nèi)灌注改變的吻合性。結(jié)果 (1)從PE發(fā)生部位分析,右側(cè)PE的比例高于左側(cè)肺動脈,肺葉動脈較左、右肺動脈干多,雙下肺動脈較雙上肺動脈多;從形態(tài)上分析,以中心型和完全閉塞型居多,附壁型次之,不規(guī)則型及馬鞍型較少;(2)在不同類型的肺動脈干PE中,完全型易發(fā)生于全肺或肺葉灌注缺損,附壁型或中心型常出現(xiàn)肺葉或段灌注缺損;若PE發(fā)生在肺葉或肺段,則完全型多出現(xiàn)肺葉或段灌注缺損,而附壁型或中心型多出現(xiàn)肺段或亞段灌注缺損或無灌注缺損;若PE發(fā)生在亞段,則多見亞段灌注缺損或無灌注缺損;(3)縱隔窗肺動脈增強圖像與肺灌注圖像診斷PE的吻合性好,肺灌注圖像與肺窗圖像診斷PE肺內(nèi)灌注改變的吻合性差。結(jié)論肺灌注成像與PE部位及形態(tài)具有一定的相關(guān)性,DSCT雙能量肺灌注成像能協(xié)助診斷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.
【作者單位】： 云南省第三人民醫(yī)院放射醫(yī)學影像科;
【分類號】：R563.5;R816.41

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