中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
1期
39-43
,共5页
富青%刘永华%雷子乔%余建明
富青%劉永華%雷子喬%餘建明
부청%류영화%뢰자교%여건명
肺栓塞%静脉血栓形成%静脉造影术%体层摄影术,X线计算机
肺栓塞%靜脈血栓形成%靜脈造影術%體層攝影術,X線計算機
폐전새%정맥혈전형성%정맥조영술%체층섭영술,X선계산궤
Pulmonary embolism%Venous thrombosis%Lower extremity%Phlebography%Tomography,X-ray computed
目的 探讨双能量CT肺动脉成像(DE-CTPA)联合间接下肢静脉造影(CTV)在诊断静脉栓塞症(VTE)中的临床应用价值.方法 对49例下肢水肿且临床怀疑肺动脉栓塞(PE)患者行DE-CTPA联合CTV检查.所有患者于CT检查前1～2d均已行下肢深静脉超声(US)检查.由2名放射专家分别对DE-CTPA和DEPI进行5级评分,并行Kappa一致性分析,同时对CTV和US诊断下肢深静脉血栓形成(DVT)的结果行配对卡方检验.结果 49例患者中PE、DVT共存21例,DE-CTPA检出PE 29例,其中CTPA检出28例,DEPI多检出1例,二者均显示PE 19例,均未显示PE18例.DEPI与CTPA在诊断PE方面存在较好的一致性(Kappa=0.7534).US检出DVT 38例,CTV检出35例并显示盆腔静脉受累25例,下腔静脉受累3例.CTV与US在诊断DVT上差异无统计学意义(P=0.625).对于VTE的检出率DE-CTPA联合CTV扫描模式较单独CTPA高30.6％(15/49).结论 DE-CTPA联合CTV扫描模式,可以对PE和DVT同时进行评估,提高VTE的诊断检出率,还可以通过肺灌注成像了解PE后的血流动力学改变,实现“一站式”检查.
目的 探討雙能量CT肺動脈成像(DE-CTPA)聯閤間接下肢靜脈造影(CTV)在診斷靜脈栓塞癥(VTE)中的臨床應用價值.方法 對49例下肢水腫且臨床懷疑肺動脈栓塞(PE)患者行DE-CTPA聯閤CTV檢查.所有患者于CT檢查前1～2d均已行下肢深靜脈超聲(US)檢查.由2名放射專傢分彆對DE-CTPA和DEPI進行5級評分,併行Kappa一緻性分析,同時對CTV和US診斷下肢深靜脈血栓形成(DVT)的結果行配對卡方檢驗.結果 49例患者中PE、DVT共存21例,DE-CTPA檢齣PE 29例,其中CTPA檢齣28例,DEPI多檢齣1例,二者均顯示PE 19例,均未顯示PE18例.DEPI與CTPA在診斷PE方麵存在較好的一緻性(Kappa=0.7534).US檢齣DVT 38例,CTV檢齣35例併顯示盆腔靜脈受纍25例,下腔靜脈受纍3例.CTV與US在診斷DVT上差異無統計學意義(P=0.625).對于VTE的檢齣率DE-CTPA聯閤CTV掃描模式較單獨CTPA高30.6％(15/49).結論 DE-CTPA聯閤CTV掃描模式,可以對PE和DVT同時進行評估,提高VTE的診斷檢齣率,還可以通過肺灌註成像瞭解PE後的血流動力學改變,實現“一站式”檢查.
목적 탐토쌍능량CT폐동맥성상(DE-CTPA)연합간접하지정맥조영(CTV)재진단정맥전새증(VTE)중적림상응용개치.방법 대49례하지수종차림상부의폐동맥전새(PE)환자행DE-CTPA연합CTV검사.소유환자우CT검사전1～2d균이행하지심정맥초성(US)검사.유2명방사전가분별대DE-CTPA화DEPI진행5급평분,병행Kappa일치성분석,동시대CTV화US진단하지심정맥혈전형성(DVT)적결과행배대잡방검험.결과 49례환자중PE、DVT공존21례,DE-CTPA검출PE 29례,기중CTPA검출28례,DEPI다검출1례,이자균현시PE 19례,균미현시PE18례.DEPI여CTPA재진단PE방면존재교호적일치성(Kappa=0.7534).US검출DVT 38례,CTV검출35례병현시분강정맥수루25례,하강정맥수루3례.CTV여US재진단DVT상차이무통계학의의(P=0.625).대우VTE적검출솔DE-CTPA연합CTV소묘모식교단독CTPA고30.6％(15/49).결론 DE-CTPA연합CTV소묘모식,가이대PE화DVT동시진행평고,제고VTE적진단검출솔,환가이통과폐관주성상료해PE후적혈류동역학개변,실현“일참식”검사.
Objective To assess the usefulness of combined dual-energy CT pulmonary angiography (DE-CTPA) and indirect CT venography (CTV) in the diagnosis of venous thromboembolism (VTE).Methods Forty-nine patients with leg swelling suspected of pulmonary embolism (PE) underwent both DE-CTPA combined with CTV and lower extremity venous ultrasound (US) in 1-2 days prior to CT.Image quality of CTPA and dual energy lung perfusion image (DEPI) was rated using a 5-point scale and the coherence between CTPA and DEPI was analyzed by Kappa statistics.The ability of CTV and US in the diagnosis of deep venous thrombosis (DVT) was compared by Chi-square test.Results Twenty-nine of 49 patients were identified with PE by DE-CTPA,including 28 patients identified by CTPA and one more by DEPI,and 21 patients were found to have both PE and DVT.Both DE-CTPA and DEPI had positive findings for pulmonary embolism in 19 patients and both had negative findings in 18 patients.There was a moderate agreement between DEPI and DE-CTPA in the assessment of PE (Kappa value =0.7534).Thirty-eight patients with DVT were identified by US,while 35 patients were identified by CTV.Among the 35 patients with DVT identified by CTV,pelvic veins were involved in 25 patients,while the inferior vena cava was involved in 3 patients.There was no significant difference between CTV and US in the diagnosis of DVT(P =0.625).The detection rate of VTE with DE-CTPA combining CTV was 30.6％ higher than that with CTPA alone.Conclusions The combined DE-CTPA and CTV achieves " one-stop" examination.It not only provides evaluation of PE and DVT and increases detection of VTE,but also depicts perfusion defect of pulmonary parenchyma that corresponds to PE.
