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目的评价多层螺旋CT在PE诊断及随访中的价值。方法81例临床怀疑PE患者采用四排探测器多层螺旋CT行CTPA,其中26例患者行联合CT静脉造影(CT venography,CTV)。对治疗患者行CT随访观察,阴性患者3个月后电话随访。结果81例患者共进行172次CTPA,25例患者检出P(E30.9%)。11例患者检出深静脉血栓(deep vein thrombolism,DVT),其中10例患者合并PE。16例大面积肺栓塞患者行溶栓及抗凝治疗,其余患者9例PE患者行抗凝治疗。随访CT证实溶栓后24h,11例PE缩小,5例消失。2周和1个月复查,除1例慢性PE保持不变,5例患者见段及亚段小栓子外,其余患者栓子消失。90d复查CT,仅有1例患者PE复发。DVT于6例患者中消失,4例缩小。CTPA阴性患者3个月后电话随访无PE临床征象。结论多层螺旋CT可以作为肺栓塞诊断与随访的有效的影像学检查方法。
Objective To evaluate the value of multislice spiral CT in the diagnosis and follow-up of PE. Methods Eighty - one cases of suspected PE patients underwent CTPA with four - detector row multislice spiral CT. Twenty - six of them underwent CT venography (CTV). CT follow-up treatment of patients treated, negative patients after 3 months of telephone follow-up. Results A total of 172 CTPAs were performed in 81 patients and P (E30.9%) in 25 patients. Eleven patients had deep vein thrombolism (DVT), of which 10 had PE. Thrombolysis and anticoagulation were performed in 16 patients with extensive pulmonary embolism. The remaining 9 patients underwent anticoagulation therapy. Follow-up CT confirmed 24h after thrombolysis, 11 cases of PE reduced, 5 cases disappeared. 2 weeks and 1 month review, except 1 case of chronic PE remain unchanged, 5 cases of patients with sub-segment and sub-emboli, the other patients with emboli disappeared. 90d review CT, only 1 patient PE recurrence. DVT disappeared in 6 patients, 4 patients reduced. CTPA-negative patients after 3 months of telephone follow-up without PE clinical signs. Conclusion Multi-slice spiral CT can be used as an effective imaging diagnosis method for pulmonary embolism diagnosis and follow-up.