【摘要】 目的评估螺旋CT肺动脉造影(CTPA)对肺动脉栓塞(PE)的诊断价值。方法97例临床可疑PE病例行CTPA检查,其中81例同时行核素灌注扫描并拍摄胸片,47例行下肢深静脉影像学检查。以非侵入性影像学诊断标准为确诊标准,评估CTPA的诊断效能,并与核素扫描比较。结果97例中,根据确诊标准诊断PE68例、除外PE29例。CTPA诊断PE的敏感度、特异度、准确度分别为95.59%、100.00%、96.29%。在同时行核素灌注扫描的81例中,根据确诊标准诊断PE58例、除外PE23例,CTPA与核素灌注扫描诊断PE的敏感度分别为94.83%、89.66%,特异度分别为100.00%、69.57%(u=3.299,P<0.001)。32例PE下肢深静脉影像学检查阳性28例(87.5%)。结论螺旋CTPA诊断PE具有很高的敏感度和特异度,应作为PE的首选影像学检查方法。更多还原

【Abstract】 Objective To assess the diagnostic value of CTPA with spiral CT in diagnosis of PE. Methods CTPA was performed in 97 patients suspected of PE. Perfusion scintigraphy combined with chest plain film was performed in 81 patients and lower extremity imaging for deep venous thrombosis (DVT) was performed in 47 of this group respectively. The diagnostic value of CTPA was evaluated and compared with that of scintigraphy based on the diagnostic standard of noninvasive imaging examination of PE. Results Based on the diagnostic standard , 68 cases were diagnosed as PE and 29 were excluded. The sensitivity, specificity, and accuracy of CTPA were 95.59%, 100.00%, and 96.91% respectively. In 81 patients who also had scintigraphy, 58 cases were diagnosed as PE and 23 were excluded based on the diagnostic standard. The sensitivity and specificity were 94.83% and 100.00% for CTPA and 89.66% and 69.57% for scintigraphy, respectively (u=3.299,P<0.001). In 32 PE patients who had lower extremities imaging, 28(87.5%) had positive findings of DVT. Conclusion Because of its high sensitivity and specificity for diagnosing PE, CTPA should be used as the first choice of imaging modality to the patients suspected of PE.更多还原