Abstract
目的 探讨多层螺旋CT肺血管造影(MDCTPA)中肺动脉栓塞(PE)直接征象与内科溶栓治疗效果的联系.方法对比分析28例PE患者于溶栓前后MDCTPA的影像表现,依据MDCTPA表现具体分型为:Ⅰ型:管腔中心充盈缺损.Ⅱ型:附壁充盈缺损并凸向腔内.Ⅲ型:附壁充盈缺损并凹向腔内.Ⅳ型:血管分支没有增强.结果 28例PE影像资料中,受累肺动脉共计93支,可分析的受累肺动脉分支(2～4级)共74支.统计提示Ⅲ型栓塞表现的内科溶栓抗凝治疗效果(23%,5/22支)显著差于Ⅰ型(95%,19/20支)与Ⅱ型(77%,20/26支),差异有显著性意义(χ2值分别为22.344和14.025 ,P值均 P<0.01).结论 MDCTPA对肺动脉栓塞影像表现的精细显示,能够对内科溶栓抗凝治疗效果进行预测,有助于制定临床治疗方案。
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