【摘要】 目的 评价多层螺旋CT血管造影(MSCTA)在诊断肺动脉栓塞(pulmonary embolism,PE)中的临床价值。方法 对26例临床疑诊为PE患者行MSCTA检查，且全部病例均经随诊证实，其中4例在溶栓治疗后进行了复查。结果 26例患者共分析1146支肺动脉及其分支，受累217支，占12.3%。肺动脉栓塞MSCTA的直接征象：肺动脉腔内类圆形、偏心形充盈缺损，附壁性充盈缺损，管腔完全闭塞，血栓位于管腔中央的轨道征。间接征象：肺动脉高压，局限性肺纹理稀疏，肺梗死，胸腔积液。结论 MSCTA是诊断PE准确、无创、有效的检查方法，且可判断溶栓疗效。

    【关键词】 肺栓塞；血管造影术；体层摄影术，螺旋计算机

    Diagnostic value of multi-slice spiral CT angiography in pulmonary embolism

    ZHANG Lin,TIAN Chun-mei,LI Zhen-yong,et al.

    Department of Radiology,The Affiliated Hospital of Binzhou Medical College,Binzhou 256603,China

    【Abstract】 Objective To evaluate the clinical value of multi-slice spiral CT angiography (MSCTA) in diagnosing pulmonary embolism (PE).Methods 26 cases,who were suspicious of PE,underwent MSCTA examinations and all were confirmed with clinical findings,4 of whom were reexamined with this method after thrombolysis.Results Embolism were founded in 217 vessels of 1146 vessels which were analysed of 26 cases.The direct signs on MSCTA were:partial filling defect,mural filling defect,total occlusion and central filling defect called railway-track sign.The indirect signs on MSCTA were:pulmonary hypertension sign,lung-marking sparse,lesion of pulmonary infarction,pleural effusions.Conclusion MSCTA is an accurate,non-invasive and effective examination for the diagnosis and follow-up of PE. ......