摘要
目的通过多层螺旋CT检查结合MRI研究肺栓塞栓子结构形态与其可溶性的关系。方法对比分析42例PE患者于溶栓前后的影像表现，对栓子的结构形态进行分析并分型：Ⅰ型管腔中心充盈缺损型；Ⅱ型附壁充盈缺损平坦型；Ⅲ型附壁充盈缺损隆起型；Ⅳ型附壁充盈缺损凹陷型；Ⅴ型血管分支无强化。把可供分析栓子根据密度高低及信号强弱进行分类，根据CT值的大小分为低密度栓子（〈40Hu）、中密度栓子（40～70Hu）、高密度栓子（〉70Hu）；按其MRI信号强度对栓子进行分型：A型为软栓子（富含水份）；B型为混合型栓子（栓子逐渐机化）；C型为硬栓子（纤维成分为主或合并钙化）。结果42例PE影像检查中受累肺动脉共计89支，可分析受累肺动脉70支。MRI可供分析受累肺动脉62支。统计结果显示高密度栓子（19％，4／21）内科抗凝溶栓治疗效果显著差于低密度栓子（83．3％，20／24），差异具有显著性意义（x^2=12．72，v=2，P〈0．005）。硬栓子（87．5％，21／24）疗效显著差于软栓子（10．5％，2／19），差异具有显著性意义（x^2=25．42，v=2，P〈0．005）。结论影像学检查可清晰显示栓子的形态结构，形态结构与可溶性有相关性，能够对内科溶栓治疗效果进行预判。
Objective An approach to the correlation between morphology of pulmonary embolism and their solvability by multi-layecd spiral CT and MRI. Methods To analyze the radiologic images in 42 PE patients undergoing thrombolysis, we classify emboli into different types：Type Ⅰ ：lumen central filling defect;Type Ⅱ ： fiat pavemengting filling defect; Type Ⅲ ： protrusion pavementing filling defect ; Type Ⅳ ： invsgination pavementing filling defect ; Type Ⅴ ： non-reinforcement of vascular arborization. We classify emboli analyzed according to CT value ：low density emboli （ 〈 40HU ）, moderate density emboli （ 40-70HU ）, high density emboli （ 〉 70HU ）. According to the signal intensity of MRI, we deride emboli into different types：Type A soft emboli （rich in water） ; Type B mixed emboli （emboli undergoing organization gradually） ,Type C hard emboli（ mainly fibre or together with calcification）. Results There are totally 89 affected pulmonary arteries in 42 PE patients, among them 70 arteries could be analyzed, 62 be analyzed by MRI. Statistical results of medical treatment in thrombolysis showed that the effect of low density emboli （83.3% ,20/24） were greater than high density emboli （ 19% ,4/21 ） ,there were statistically significant difference between them. （X^2 = 12.72, v = 2 ,P 〈 0. 005 ）. Soft emboli （10. 5%, 2/19） were significantly greater than hard emboli （87. 5 %, 21/24）, there were statisctically significant difference between them. （X^2 = 25.42, v = 2, P 〈 0. 005 ）. Conclusion Radioscopy can clearly show the morphology and structure of emboli, there were correlation between morphology of emboli and their solvability, prediction of the effect of medical treatmengt in thromblysis can be made.
出处
《中国临床实用医学》
2009年第3期26-28,共3页
China Clinical Practical Medicine
关键词
肺动脉栓塞
形态结构
体层摄影术
X线计算机
磁共振成像
Pulmeonary embolism
Morphology and structure
Tomography
X-ray computed
Angiogra- phy
Magnetic resonance imaging
