多层螺旋CT血管造影对肺动脉栓塞诊断和疾病严重程度的评价价值张辉，邹利光，逢鑫，文利，杨华，梁开运，席道友(第三军医大学新桥医院放射科，重庆400037)摘要：目的探讨多层螺旋CT血管造影(CTA)对帅动脉栓塞的诊断价值，评价帅动脉栓塞CTA表现「疾病严重程度的关系。方法回顾性分析肺动脉栓塞36例临床和影像资料，所冇患者均使用GELightSpeed64层螺旋CT或e-Speed电子束CT行常规扫描及CTA,横轴位图像和多种后处理技术观察肺动脉改变及相关征象。结果36例共2070支肺动脉纳入分析，748支显示了栓塞，占36.1%。216支肺叶动脉中，75支显示了栓塞(34.7%),720支肺段动脉中，319支显示了栓寒(44.3%),1134支亚段肺动脉中，354支显示了栓塞(31.2%)。根据临床表现将患者分为危重组和非危重组,危重组15例,肺动脉栓塞指数为(56.7土11.3)%，中央肺动脉受累39支(43.3%),右心室最大短轴和左心室最大短轴比(RV:LV比)为(1.46土0.62)。非危重组21例，肺动脉栓塞指数为(27.4±9.6)%,中央肺动脉受累36支(28.6%),RV:LV比为(1.()6±0.35),两组指标测量结果差异均有统计学意义。结论多层螺旋CT血管造影可直观地显示有无肺动脉栓塞、病变范围和严重程度，肺动脉栓塞指数>40%可作为诊断大而积肺动脉栓塞的重要指标。关键词：肺栓塞；肺动脉；体层摄影术，X线计算机中图法分类号：文献标识码：AMultislicespiralCTangiographyindiagnosisandseverityassessmentofpulmonaryembolism:reportof36casesZHANGHui,ZOULi-guang,PANGXin,WENLi,YANGHua,LIANGKai-yun,XIDao-you(DepartmentofRadiology,XinqiaoHospital,ThirdMilitaryMedicalUniversity,Chongqing400037,China)Abstract:ObjectiveTostudythediagnosticvalueofmultislicespiralCTangiography(CTA)inthediagnosisandseverityassessmentofpulmonaryembolism(PE).MethodsClinicalandimagingdataof36casesofPEadmittedinourhospitalduringMay2005toMarch2009werereviewedretrospective!y.AllpatientsunderwentconventionalCTscanningandCTAwith64-slicespiralCTore-SpeedelectronbeamCTscanning(GEMedicalSystem,Milwaukee,WI).Axialsectionandsonicpost-processedimages,includingmaximumintensityprojection(MIP),multiplanarreconstruction(MPR),volumerederening(VR)andvirtualendoscopy(VE)wereanalyzed・ResultsIn36casesofPE,2070branchesofpulmonaryarterywereanalyzedandPEwasdetectedin748branches(36.1%).In216lobararteries,PEwasdetectedin75branches(34.7%),in720segmentalarteriesPEwasdetectedin319branches(43.3%),andin1134subsegmentalarteriesPEwasdetectedin354branches(31.2%).Basedonclinicalmanifestationsthepatientswereclassifiedinto2groups,severegroupandnon-severegroup・In15casesofseveregroup,pulmonaryembolismindexwas(56.7+11.3)%,thecentralpulmonaryarterywasinvolvcdin39branches(43.3%),andtherightventricle/leftventriclemaximumminoraxisratio(RV:LVratio)1.46±0.62.In21casesofnon-severegroup,pulmonaryembolismindexwas(27・4±9・6)%,centralpulnlonaryarterywasinvoIvedin36branches(28.6%),andtheRV:LVratiowas1.06±0.35・Thedifferenceoftheparametersbetween2groupswasstatisticallysignificani(Pv0・05,0.01).ConclusionMultislicespiralCTangiographydisplaysPEintuitivelyanddeterminesitsextentandseverity.Ourdatasuggestthatpulmonaryembolismindex>40%canbeusedastheimportantcriteriaforthediagnosisoflargeareaPE.Keywords:pulmonaryembolism;pulmonaryartery;X-raycomputedtomography基金项目：国家自然科学基金(307706()9)；車庆市自然科学基金(CSTC2(X)6BB51()4)SupportedbytheNationalNaturalScienceFoundationofChina(30770609)andtheNaturalScienceFoundationofChongqing(2(X)6BB51()4)作者简介：张辉，男，黑龙江省哈尔滨市人，硕士研究生.主要从申胸部疾病放射诊断方面的研尤。电话：(023)68774676,E-mail:zhanghuipx721@163.com通信作者：邹利光,电话：(023)68774676,E-mail:zoulg@...