• 廣西壯族自治區(qū)人民醫(yī)院呼吸內(nèi)科（廣西南寧 530021）;

肺栓塞( PE) 的確診依賴于肺動脈的影像學(xué)檢查。電子計算機斷層掃描肺動脈造影( CTPA) 診斷PE 的敏感性和特異性高[ 1] , 而且該項檢查是無創(chuàng)技術(shù), 患者痛苦小, 并發(fā)癥
少, 已成為診斷PE 的一線技術(shù)[ 2,3] 。隨著CT 儀器的不斷升級和改進以及檢查技術(shù)的不斷研究, CT 在PE 中的應(yīng)用不再僅限于PE 的定性診斷, 還用于肺動脈栓塞程度的量化、右心室改變的診斷、患者預(yù)后判斷以及下肢深靜脈血栓形成( DVT) 的診斷等。

引用本文： 秦志強. 電子計算機斷層掃描在肺栓塞中的應(yīng)用. 中國呼吸與危重監(jiān)護雜志, 2010, 9(1): 104-106. doi: 復(fù)制

1. .Stein PD,Fowler SE,Goodman LR,et al.Multidetector computed tomography for acute pulmonary embolism.N Engl J Med,2006,354:2317-2327.
2. .Revel MP,Petrover D,Hernigou A,et al.Diagnosing pulmonary embolism with four-detector row helical CT:prospective evaluation of 216 outpatients and inpatients.Radiology,2005,234:265-273.
3. .Weiss CR,Scatarige JC,Diette GB,et al.CT pulmonary angiography is the first-line imaging test for acute pulmonary embolism:a survey of US clinicians.Acad Radiol,2006,13:434-446.
4. .Winer-Muram HT,Rydberg J,Johnson MS et al.Suspected acute pulmonary embolism:evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography.Radiology,2004,233:806-815.
5. .Baile EM,King GG,Müller NL,et al.Spiral computed tomography is comparable to angiography for the diagnosis of pulmonary embolism.Am J Respir Crit Care Med,2000,161:1010-1015.
6. .Wittram C,Waltman AC,Shepard JA,et al.Discordance between CT and angiography in the PIOPED II study.Radiology.2007,244:883-889.
7. .Katsouda E,Mystakidou K,Rapti A,et al.Evaluation of spiral computed tomography versus ventilation/perfusion scanning in patients clinically suspected of pulmonary embolism.In Vivo,2005,19:873-878.
8. .Reinartz P,Wildberger JE,Schaefer W,et al.Tomographic imaging in the diagnosis of pulmonary embolism:a comparison between V/Q lung scintigraphy in SPECT technique and multislice spiral CT.J Nucl Med,2004,45:1501-1508.
9. .Nazaro?lu H,Ozmen CA,Akay HO,et al.64-MDCT pulmonary angiography and CT venography in the diagnosis of thromboembolic disease.AJR Am J Roentgenol,2009,192:654-661.
10. .Qanadli SD,El Hajjam M,Vieillard-Baron A,et al.New CT index to quantify arterial obstruction in pulmonary embolism:comparison with angiographic index and echocardiography.AJR Am J Roentgenol,2001,176:1415-1420.
11. .Mastora I,Remy-Jardin M,Masson P,et al.Severity of acute pulmonary embolism:evaluation of a new spiral CT angiographic score in correlation with echocardiographic data.Eur Radiol,2003,13:29-35.
12. .Contractor S,Maldjian PD,Sharma VK,et al.Role of helical CT in detecting right ventricular dysfunction secondary to acute pulmonary embolism.J Comput Assist Tomogr,2002,26:587-591.
13. .Mansencal N,Joseph T,Vieillard-Baron A,et al.Diagnosis of right ventricular dysfunction in acute pulmonary embolism using helical computed tomography.Am J Cardiol,2005,95:1260-1263.
14. .Terao M,Ozaki T,Sato T.Diagnosis of deep vein thrombosis after operation for fracture of the proximal femur:comparative study of ultrasonography and venography.J Orthop Sci,2006,11:146-153.
15. .Garcia-Bolado A,Del Cura JL.CT venography vs ultrasound in the diagnosis of thromboembolic disease in patients with clinical suspicion of pulmonary embolism.Emerg Radiol,2007,14:403-409.
16. .Goodman LR,Stein PD,Matta F,et al.CT venography and compression sonography are diagnostically equivalent:data from PIOPED II.AJR Am J Roentgenol,2007,189:1071-1076.
17. .Ghaye B,Ghuysen A,Willems V,et al.Severe pulmonary embolism:pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality.Radiology,2006,239:884-891.
18. .Araoz PA,Gotway MB,Harrington JR,et al.Pulmonary embolism:prognostic CT findings.Radiology,2007,242:889-897.
19. .Pech M,Wieners G,Dul P,et al.Computed tomography pulmonary embolism index for the assessment of survival in patients with pulmonary embolism.Eur Radiol,2007,17:1954-1959.
20. .Schoepf UJ,Kucher N,Kipfmueller F,et al.Right ventricular enlargement on chest computed tomography:a predictor of early death in acute pulmonary embolism.Circulation,2004,110:3276-3280.
21. .Wu AS,Pezzullo JA,Cronan JJ,et al.CT pulmonary angiography:quantification of pulmonary embolus as a predictor of patient outcome--initial experience.Radiology,2004,230:831-835.
  1. 1. .Stein PD,Fowler SE,Goodman LR,et al.Multidetector computed tomography for acute pulmonary embolism.N Engl J Med,2006,354:2317-2327.
  2. 2. .Revel MP,Petrover D,Hernigou A,et al.Diagnosing pulmonary embolism with four-detector row helical CT:prospective evaluation of 216 outpatients and inpatients.Radiology,2005,234:265-273.
  3. 3. .Weiss CR,Scatarige JC,Diette GB,et al.CT pulmonary angiography is the first-line imaging test for acute pulmonary embolism:a survey of US clinicians.Acad Radiol,2006,13:434-446.
  4. 4. .Winer-Muram HT,Rydberg J,Johnson MS et al.Suspected acute pulmonary embolism:evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography.Radiology,2004,233:806-815.
  5. 5. .Baile EM,King GG,Müller NL,et al.Spiral computed tomography is comparable to angiography for the diagnosis of pulmonary embolism.Am J Respir Crit Care Med,2000,161:1010-1015.
  6. 6. .Wittram C,Waltman AC,Shepard JA,et al.Discordance between CT and angiography in the PIOPED II study.Radiology.2007,244:883-889.
  7. 7. .Katsouda E,Mystakidou K,Rapti A,et al.Evaluation of spiral computed tomography versus ventilation/perfusion scanning in patients clinically suspected of pulmonary embolism.In Vivo,2005,19:873-878.
  8. 8. .Reinartz P,Wildberger JE,Schaefer W,et al.Tomographic imaging in the diagnosis of pulmonary embolism:a comparison between V/Q lung scintigraphy in SPECT technique and multislice spiral CT.J Nucl Med,2004,45:1501-1508.
  9. 9. .Nazaro?lu H,Ozmen CA,Akay HO,et al.64-MDCT pulmonary angiography and CT venography in the diagnosis of thromboembolic disease.AJR Am J Roentgenol,2009,192:654-661.
  10. 10. .Qanadli SD,El Hajjam M,Vieillard-Baron A,et al.New CT index to quantify arterial obstruction in pulmonary embolism:comparison with angiographic index and echocardiography.AJR Am J Roentgenol,2001,176:1415-1420.
  11. 11. .Mastora I,Remy-Jardin M,Masson P,et al.Severity of acute pulmonary embolism:evaluation of a new spiral CT angiographic score in correlation with echocardiographic data.Eur Radiol,2003,13:29-35.
  12. 12. .Contractor S,Maldjian PD,Sharma VK,et al.Role of helical CT in detecting right ventricular dysfunction secondary to acute pulmonary embolism.J Comput Assist Tomogr,2002,26:587-591.
  13. 13. .Mansencal N,Joseph T,Vieillard-Baron A,et al.Diagnosis of right ventricular dysfunction in acute pulmonary embolism using helical computed tomography.Am J Cardiol,2005,95:1260-1263.
  14. 14. .Terao M,Ozaki T,Sato T.Diagnosis of deep vein thrombosis after operation for fracture of the proximal femur:comparative study of ultrasonography and venography.J Orthop Sci,2006,11:146-153.
  15. 15. .Garcia-Bolado A,Del Cura JL.CT venography vs ultrasound in the diagnosis of thromboembolic disease in patients with clinical suspicion of pulmonary embolism.Emerg Radiol,2007,14:403-409.
  16. 16. .Goodman LR,Stein PD,Matta F,et al.CT venography and compression sonography are diagnostically equivalent:data from PIOPED II.AJR Am J Roentgenol,2007,189:1071-1076.
  17. 17. .Ghaye B,Ghuysen A,Willems V,et al.Severe pulmonary embolism:pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality.Radiology,2006,239:884-891.
  18. 18. .Araoz PA,Gotway MB,Harrington JR,et al.Pulmonary embolism:prognostic CT findings.Radiology,2007,242:889-897.
  19. 19. .Pech M,Wieners G,Dul P,et al.Computed tomography pulmonary embolism index for the assessment of survival in patients with pulmonary embolism.Eur Radiol,2007,17:1954-1959.
  20. 20. .Schoepf UJ,Kucher N,Kipfmueller F,et al.Right ventricular enlargement on chest computed tomography:a predictor of early death in acute pulmonary embolism.Circulation,2004,110:3276-3280.
  21. 21. .Wu AS,Pezzullo JA,Cronan JJ,et al.CT pulmonary angiography:quantification of pulmonary embolus as a predictor of patient outcome--initial experience.Radiology,2004,230:831-835.