【摘要】 目的评价多层螺旋CT在PE诊断及随访中的价值。方法81例临床怀疑PE患者采用四排探测器多层螺旋CT行CTPA,其中26例患者行联合CT静脉造影(CT venography,CTV)。对治疗患者行CT随访观察,阴性患者3个月后电话随访。结果81例患者共进行172次CTPA,25例患者检出P(E30.9%)。11例患者检出深静脉血栓(deep vein thrombolism,DVT),其中10例患者合并PE。16例大面积肺栓塞患者行溶栓及抗凝治疗,其余患者9例PE患者行抗凝治疗。随访CT证实溶栓后24h,11例PE缩小,5例消失。2周和1个月复查,除1例慢性PE保持不变,5例患者见段及亚段小栓子外,其余患者栓子消失。90d复查CT,仅有1例患者PE复发。DVT于6例患者中消失,4例缩小。CTPA阴性患者3个月后电话随访无PE临床征象。结论多层螺旋CT可以作为肺栓塞诊断与随访的有效的影像学检查方法。更多还原

【Abstract】 [Objective] To evaluate the role of multi-slice spiral CT in diagnosis and follow-up of PE. [Methods] CT pulmonary angiography was performed in 81 patients who were suspected with PE using a four-channel multi-slice spiral CT, and combined CT veinography (CTV) were carried out in 26 patients. Treated patients received follow-up CT examinations after therapy, while those with negative results at CT pulmonary angiography were contacted by telephone after 3 months. [Results] One hundred and seventy-two CT examinations were performed in the 81 patients. PE was detected in 25 patients (30.9%). Eleven cases with deep vein thrombosis (DVT) were observed and ten cases were complicated with PE. Sixteen patients with massive PE underwent thromboslysis therapy and anticoagulant therapy. Another nine patients with non-massive PE underwent anticoagulant therapy. Follow-up CT pulmonary angiography confirmed that the clots became smaller in 11 cases and disappeared in 5 cases at 24 hours after the beginning of thrombolysis therapy. Small segmental or subsegmental emboli were observed in 5 cases after two weeks and one month following-up CT examination from the beginning of therapy, and clots in a patient with chronic PE kept unchanged, while the PE disappeared in the remained cases. At the 90th day following-up CT examinations, there was only one patient with the reoccurrence of PE. Deep vein thrombosis was disappeared in six patients and became smaller in four patients during the follow-up. No clinical findings of PE were documented in the negative cases at the telephone contact after three months. [Conclusion] Multislice spiral CT is an efficient imaging modality for diagnosis and follow-up of PE.更多还原