CAJ | 학술논문

目的：探讨16层螺旋 CT 不同重建方式在肺动脉栓塞中的应用价值。方法2013年10月至2014年5月在我院就诊疑似肺动脉栓塞的患者30例，分别行胸部 CT 平扫及肺动脉造影（CTPA）扫描，图像后处理多平面重建（MPR）、最大密度投影（MIP）及容积再现（VR）技术。由两名放射科医师共同阅片，分析不同重建方式对栓子的检出率。结果30例患者中发现肺动脉栓塞24例，栓子138个，轴位及 MPR 共检出138个（100％），MIP 共检出108个（78．2％），VR 共检出68个（49．3％），MPR、MIP 及 VR 图像检出肺动脉主干及肺叶动脉的栓子数目相同，分别为4、31个，肺段级血管内栓子数目分别为47、45、26个；亚段肺动脉及其以下分支内栓子数目分别为56、28、7个，三种重建方式对栓子的总检出率差异有统计学意义（P＜0．05）；在肺叶动脉以上平面对栓子的检出率差异无统计学意义（P ＞0．05）；在肺段动脉平面，除 MPR 与 MIP 外，其余差异有统计学意义（P ＜0．05）；在肺亚段及以下平面，三种重建方式间差异有统计学意义（P ＜0．05）。结论MPR 和 MIP 对肺动脉栓塞栓子的检出率高，几种重建方式综合运用更加有利于栓子的显示。
목적：탐토16층라선 CT 불동중건방식재폐동맥전새중적응용개치。방법2013년10월지2014년5월재아원취진의사폐동맥전새적환자30례，분별행흉부 CT 평소급폐동맥조영（CTPA）소묘，도상후처리다평면중건（MPR）、최대밀도투영（MIP）급용적재현（VR）기술。유량명방사과의사공동열편，분석불동중건방식대전자적검출솔。결과30례환자중발현폐동맥전새24례，전자138개，축위급 MPR 공검출138개（100％），MIP 공검출108개（78．2％），VR 공검출68개（49．3％），MPR、MIP 급 VR 도상검출폐동맥주간급폐협동맥적전자수목상동，분별위4、31개，폐단급혈관내전자수목분별위47、45、26개；아단폐동맥급기이하분지내전자수목분별위56、28、7개，삼충중건방식대전자적총검출솔차이유통계학의의（P＜0．05）；재폐협동맥이상평면대전자적검출솔차이무통계학의의（P ＞0．05）；재폐단동맥평면，제 MPR 여 MIP 외，기여차이유통계학의의（P ＜0．05）；재폐아단급이하평면，삼충중건방식간차이유통계학의의（P ＜0．05）。결론MPR 화 MIP 대폐동맥전새전자적검출솔고，궤충중건방식종합운용경가유리우전자적현시。
Objective To investigate the application value of different reconstruction methods of 16-slice spiral CT in pulmo-nary embolism.Methods Thirty patients who were suspected of pulmonary embolism were recruited during Oct .2013 to May.2014. Chest routine scan and CT pulmonary arteriography were applied ,respectively.Technique of multiplanar reconstruction (MPR),maxi-mum intensity projection(MIP),and volume rendering(VR)were used in image post-processing.Detection rate of embolus by different reconstruction methods were analyzed by two radiologists .Results Of all the 30 patients,138 emboli were found in twenty-four pa-tients.The detection rates of axial view as well as MRP ,MIP,and VR were 138(100%),108(78.2%)and 68(49.3%),respectively. The emboli of main pulmonary artery and lobar artery were 4 and 31,respectively,which were all detected by MPR,MIP and VR.Num-ber of emboli in segment artery which detected by MRP ,MIP,and VR were 47,45,and 26,respectively.Those in sub-segment and be-low artery were 56,28,and 7,respectively.There were significant differences in three different reconstruction methods in total detection rate of emboli and in sub-segment and below artery.Statistic differences were found in segment artery level except MRP and MIP .No difference in detection rate was found in lobar artery and above level .Conclusion MPR and MIP have high detection rate of embolus in pulmonary embolism.Integration of several reconstruction methods shows conducive visualization of embolus .