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目的:观察320排计算机断层扫描(CT)与64排CT的肺血管成像技术对不同水平肺动脉分支及其内栓子的显示情况,评价两者的诊断效能,提高肺栓塞的诊断水平。方法:收集34例肺栓塞患者多排螺旋CT肺血管成像(CTPA)图像,20例行320排CT检查、14例行64排CT检查,记录肺动脉、肺动脉干、叶、段、亚段、5、6级肺动脉支数及肺动脉栓子数,比较不同CT对各级肺动脉分支及动脉内栓子的显示有否差别。结果:共有68支肺动脉干、170支叶动脉、594支段动脉、600支亚段动脉、296支5级分支、116支6级分支可供分析。检出肺动脉干栓子13个、叶动脉栓子48个、段动脉栓子173个、亚段动脉栓子145个、5级分支栓子13个、6级分支栓子6个。320排CT与64排CT在肺动脉干、叶动脉、段动脉、亚段动脉及其栓子的显示差异无统计学意义(P>0.05);320排CT与64排CT在肺动脉5、6级分支及其栓子的显示,差异具有统计学意义(P<0.05)。结论:320排CT、64排CT的CTPA在显示亚段以上水平肺动脉分支及其栓子方面具有同等的诊断效能,可对中央性肺栓塞作出准确诊断;320排CT在5、6级肺动脉分支及其栓子的显示上具有优势,对诊断外周性肺动脉栓塞有重要的意义。
OBJECTIVE: To observe the display of 320 pulmonary CT and 64-slice CT pulmonary angiography in different levels of pulmonary artery branches and their internal emboli, and to evaluate their diagnostic efficacy and the diagnostic value of pulmonary embolism. Methods: Thirty-four patients with pulmonary embolism were enrolled in this study. Multislice spiral CT pulmonary angiography (CTPA) was performed in 20 patients. Twenty-four patients underwent 320-slice CT and 14 patients underwent 64-slice CT. Pulmonary artery, pulmonary artery, , Grade 6 pulmonary artery and pulmonary embolism, CT comparison of different levels of pulmonary artery branches and arterial embolization showed any difference. RESULTS: A total of 68 pulmonary arteries, 170 leaf arteries, 594 arteries, 600 arteries, 296 fifth-grade branches and 116 sixth-level branches were available for analysis. Thirteen pulmonary embolus, pulmonary artery embolus 48, segment arterial embolus 173, sub-segment arterial emboli 145, grade 5 branch thrombus 13 and grade 6 branch thrombus 6 were detected. There was no significant difference between 320-slice CT and 64-slice CT in displaying pulmonary artery, leaf arteries, segmental arteries, sub-arteries and their emboli (P> 0.05) Branches and emboli showed significant differences (P <0.05). Conclusions: CTPA in 320-slice CT and 64-slice CT has the same diagnostic efficacy in displaying horizontal pulmonary artery branches and emboli in the sub-section, which can make an accurate diagnosis of central pulmonary embolism. The 320-slice CT in the pulmonary artery of grade 5 and 6 And its embolism display on the advantages of the diagnosis of peripheral pulmonary embolism has important significance.