【摘要】 目的探讨肺动脉CT血管造影后深静脉扫描对深静脉血栓的位置、范围及管腔狭窄程度的诊断价值,并与下肢静脉造影结果进行对照。方法19例疑诊肺栓塞的患者,接受肺动脉CT血管造影后深静脉扫描,其中男8例,女11例,年龄38~73岁。CT肺动脉造影扫描范围从膈顶至主动脉弓水平。其中15例接受双下肢静脉造影,扫描范围从膈顶至小腿上端。分别观察2种检查方法的影像结果,并将下肢静脉影像进行比较分析。结果全部19例患者行肺动脉CT血管造影后深静脉扫描,所有病例均获得满意的肺部图像,18例获得良好的深静脉扫描图像,1例深静脉显影不良,不能诊断。7例有不同程度和范围的肺动脉栓塞,11例见有深静脉血栓,其中既有肺动脉栓塞又有深静脉血栓者6例,1例仅有肺动脉栓塞而无深静脉血栓,5例仅有深静脉血栓而无肺动脉栓塞。15例患者在CT检查前后24h接受下肢静脉造影检查,10例呈阳性,显示血栓分别位于静脉和股静脉。10例下肢静脉血栓病例,CT检查发现9例,漏诊1例;而CT发现的股静脉以上平面的深静脉血栓4例,下肢静脉造影受其技术方法限制,均未能显示。结论CT肺动脉造影除能够发现肺栓塞的部位及其他非栓塞病变外,对下肢、盆腔及腹部的静脉扫描,还可准确地诊断深静脉血栓。更多还原

【Abstract】 Objective:To determine the location and extension of deep venous thrombosis on CT venography after pulmonary CT angiography in patients clinically suspected of having pulmonary embolism and to compare the accuracy of CT venography with lower-extremity venography.Methods:Deep venous images were acquired after pulmonary CT angiography in 19 patients clinically suspected of having pulmonary embolism.11 women,8 men;aged 38～73,mean age,55.5 years.The scan extension of pulmonary CT angiography goes from the diaphragm to the aortic arch and that of deep venography,from the diaphragm to the upper calves.The presence and location of deep venous thrombosis were analyzed and compared with those of lower-extremity venography in 15 patients. Results:Satisfactory CT images of deep venography were obtained in all 19 patients except one.12 cases had pulmonary embolism and/or deep venous thrombosis,in which 1 patient showed pulmonary embolism alone,5 patients,deep venous thrombosis alone,and 6 patients had both.Among 11 patients with deep venous thrombosis,4 cases of thrombus proximal to the femoral vein were not detected by lower-extremity venography,whereas 10 patients showed femoropopliteal deep venous thrombosis by lower-extremity venography,9 cases were detected by CT venography.Conclusion:Pulmonary CT angiography can define pulmonary embolism and other non-embolic pulmonary diseases.The combination of CT venography with pulmonary angiography can also accurately depict pelvic,abdominal and lower-extremity thrombi.更多还原