【摘要】 目的评价多层螺旋CT肺血管成像(MSCTPA)对肺动静脉畸形(PAVMs)的诊断价值。方法回顾性分析10例肺动静脉畸形的临床和MSCT表现。采用16层螺旋CT扫描仪,增强后分两期扫描,延迟时间分别为7～9s和21～23s。图像传后处理工作站进行血管重建,重建方法包括VR、MIP、MPR。结果CTA后处理血管重建可以显示供血动脉、畸形血管团、引流静脉,供血动脉的来源、引流静脉的去处也充分易显示。按病变形态与影像表现,肺动静脉畸形CT后处理表现分为三型:单纯型5例,复杂型2例,弥漫型3例。临床上单纯型均为体检发现,复杂型2例中1例体检发现,1例表现反复咯血;弥漫型3例患者均表现低氧血症。结论不同类型PAVMs,其临床表现、CT征象各异。MSCTPA可取代常规血管造影成为PAVMs的首选检查和诊断方法。更多还原

【Abstract】 Objective To evaluate the diagnostic value of multi-slice spiral computed tomography pulmonary angiography (MSCTPA) for Pulmonary arteriovenous malforma- tions (PAVMs). Methods Ten patients with PAVMs were retrospectively reviewed. The CT angiography was performed using a 16-slice computed tomography scanner. After ad- ministering contrast medium, elay scan time was 7~9s and 21～23s. Imaging of pulmonary vessels were performed at post-process workstation, incluing VR, MIP, MPR constructions. Results Construction process of MSCTPA can show feeding artery, nidus and drainage vein. The origin of the feeding arteries and drainage vein were easy to demonstrate too. The image of PAVMs can be divided into 3 types: Five patients were simple type, Two patients were complex type and three patients were diffuse type. 6 cases of PAVMs without clinical symptoms, including 5 cases simple types and 1 case complex type, were all discovered on a chest radiography or CT during annual checkup;1 case of complex type was found hemop- tysis repeatedly; 3 patients of diffuse type all showed hypoxemia. Conclusion Different types of PAVMs show different clinical manifestations and CT features, which suggests MSCTPA should be used as the first choice of the examination and the diagnosis of pulmo- nary arteriovenous malformations.更多还原