CT肺血管造影和双能量肺灌注成像对肺栓塞的诊断价值

摘要

Objective To discuss the effectiveness of application of CTPA (CT Pulmonary Angiography) and DEPI (Dual Energy Perfusion Imaging) in the diagnosis of pulmonary embolism. Methods A retrospective analysis of clinical data of 31 clinically-diagnosed patients with pulmonary embolism was made. All patients underwent pulmonary artery angiography under the mode of dual energy so as to obtain two groups of data (CTPA data and DEPI data). CTPA data and DEPI data were taken as Group A1 and Group A2 respectively. Analysis of A1 Group could display whether the pulmonary artery thrombus existed and the degree of embolization; while, analysis of Group A2 could determine the pulmonary perfusion defects, and the degree of defects. The correlation between CTPA and DEPI was analyzed. Results Images of A1 and A2 Group had no statistically signiifcant difference in displaying of embolus and thrombotic degree of pulmonary stem (Grade I) and lobar artery (Grade II) (P>0.05). While, statistically signiifcant difference was seen in displaying of pulmonary segmental artery (Grade III) and pulmonary sub-segment artery (Grade IV) (P<0.05). Conclusion CTPA and DEPI showed different indicators in diagnosis of pulmonary embolism, combination of these two methods could improve the accuracy in diagnosis of the disease.%目的：探讨CT肺血管造影（CTPA）和肺血管灌注成像（DEPI）对肺栓塞的诊断价值。方法回顾性分析31例经临床确诊为肺动脉栓塞患者的临床资料。所有患者均在双能量模式下行肺动脉造影检查，同时获得两组数据，即CTPA图像数据和DEPI图像数据。将CTPA图像数据设为A1组，DEPI图像数据设为A2组，分析A1组图像显示的肺动脉内有无血栓及栓塞程度；分析A2组图像显示的肺灌注缺损及缺损程度，并分析CTPA和DEPI结果的相关性。结果A1组、A2组图像在显示肺动脉干（Ⅰ级）、肺叶肺动脉（Ⅱ级）的血栓及栓塞程度方面，差异无统计学意义（P>0.05）；在显示肺段肺动脉（Ⅲ级）及亚段肺动脉（Ⅳ级）方面有显著差异（P<0.05）。结论CTPA和DEPI关于肺栓塞的诊断指标有一定差异性，结合两种检查手段可提高肺栓塞的诊断准确性。