CAJ | 학술논문

目的探讨建立CT肺动脉(PA)及支气管动脉(BA)联合造影的方法及其对咯血患者的诊断价值.方法连续纳入北京朝阳医院2007年6月至2009年7月36例中等量及以上咯血住院患者,其中男21例,女5例,年龄27 ～ 83岁,平均(56±14)岁.使用16排螺旋CT,静脉注射对比剂后,首先完成CT肺动脉造影(CTPA),延迟时间12～16 s,继之完成CT支气管动脉造影(CTBA),延迟时间26～28 s,经图像重建后对PA及BA进行评价.结果 36例患者CTPA检查发现7例PA异常(肺栓塞3例,PA畸形、原发性PA平滑肌肉瘤、PA边缘模糊及右下PA闭塞各1例).36例患者CTBA检查共显示37支右侧BA,其中11支迂曲增粗、40支左侧BA及3支非支气管体循环动脉,其中来源于腹主动脉的1支迂曲增粗.异常血管与肺部疾病关系密切.结论利用16排螺旋CT技术,可进一步完成CTPA及CTBA检查,清楚显示异常的PA及BA,对咯血的诊断及治疗具有重要价值.
목적 탐토건립CT폐동맥(PA)급지기관동맥(BA)연합조영적방법급기대각혈환자적진단개치.방법 련속납입북경조양의원2007년6월지2009년7월36례중등량급이상각혈주원환자,기중남21례,녀5례,년령27 ～ 83세,평균(56±14)세.사용16배라선CT,정맥주사대비제후,수선완성CT폐동맥조영(CTPA),연지시간12～16 s,계지완성CT지기관동맥조영(CTBA),연지시간26～28 s,경도상중건후대PA급BA진행평개.결과 36례환자CTPA검사발현7례PA이상(폐전새3례,PA기형、원발성PA평활기육류、PA변연모호급우하PA폐새각1례).36례환자CTBA검사공현시37지우측BA,기중11지우곡증조、40지좌측BA급3지비지기관체순배동맥,기중래원우복주동맥적1지우곡증조.이상혈관여폐부질병관계밀절.결론 이용16배라선CT기술,가진일보완성CTPA급CTBA검사,청초현시이상적PA급BA,대각혈적진단급치료구유중요개치.
Objective To establish the method of multi-slice spiral CT pulmonary angiography (CTPA) combined with bronchial angiography(CTBA) and to evaluate its value for diagnosis and treatment in hemoptysis.Methods After contrast material was administered intravenously,a 16-detector row helical CT scanner (Light Speed Ultra 16; GE Medical Systems) was used to complete CTPA first with a scan delay time of 12 - 16 s.Then CTBA was carried out,with a scan delay time of 26 - 28 s.The images were reformatted to evaluate the pulmonary artery and bronchial artery (BA). Results In 36 cases of hemoptysis,CTPA showed 7 pulmonary arterial abnormalities ( 3 cases with pulmonary embolism,4 cases with one of pulmonary artery abnormity,primary pulmonary artery leiomyosarcoma,loss of sharpness of pulmonary artery or occlusion of right-inferior lung artery).In the 36 cases,CTBA showed 37 right BAs (11 tortuosity and thickening),40 left right BAs (10 tortuosity and thickening)and 3 non-bronchial systemic arteries( 1 from abdominal aorta tortuosity and thickening).Abnormal vessels had a close relation with pulmonary diseases. Conclusions With this method CTPA and CTBA can be completed in a single procedure and abnormal pulmonary arteries and bronchial arteries can be shown clearly.This procedure maybe of important value for the diagnosis and treatment of hemoptysis.