CAJ | 학술논문

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[1-2]: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(<40 Hu)、中密度栓子(40～70 Hu)、高密度栓子(>70 Hu);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(χ2=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(χ2=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.
목적통과다층라선CT검사결합MRI연구폐전새전자결구형태여기가용성적관계.방법대비분석42례PE환자우용전전후적영상표현,대전자적결구형태진행분석병분형[1-2]:Ⅰ형관강중심충영결손형;Ⅱ형부벽충영결손평탄형;Ⅲ형부벽충영결손륭기형;Ⅳ형부벽충영결손요함형;Ⅴ형혈관분지무강화.파가공분석전자근거밀도고저급신호강약진행분류,근거CT치적대소분위저밀도전자(<40 Hu)、중밀도전자(40～70 Hu)、고밀도전자(>70 Hu);안기MRI신호강도대전자진행분형:A형위연전자(부함수빈);B형위혼합형전자(전자축점궤화);C형위경전자(섬유성분위주혹합병개화).결과 42례PE영상검사중수루폐동맥공계89지,가분석수루폐동맥70지.MRI가공분석수루폐동맥62지.통계결과현시고밀도전자(19%,4/21)내과항응용전치료효과현저차우저밀도전자(83.3%,20/24),차이구유현저성의의(χ2=12.72,v=2,P<0.005).경전자(87.5%,21/24)료효현저차우연전자(10.5%,2/19),차이구유현저성의의(χ2=25.42,v=2,P<0.005).결론영상학검사가청석현시전자적형태결구,형태결구여가용성유상관성,능구대내과용전치료효과진행예판.
Objective An approach to the correlation between morphology of pulmonary embolism and their solvability by muhi-layecd spiral CT and MRI. Methods To analyze the radiologic images in 42 PE pa-tients 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 pave-menting filling defect; Type Ⅴ: non-reinforcement of vascular arborization. We classify emboli analyzed accord-ing to CT value: low density emboli (<40HU), moderate density emboli(40-70HU), high density emboli(>70HU). According to the signal intensity of MRI ,we devide emboli into different types:Type A soft emboli(richin 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, a-mong 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 embo-li(19%, 4/21),there were statistically significant difference between them. (χ2=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 statiscti-cally significant difference between them. (χ2=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.