78例肺血栓栓塞症MRI检查的临床分析
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【摘要】目的 探讨MRI检查对肺动脉血栓栓塞症(PTE)的诊断价值。方法 对78例临床和肺血管造影检查(DSA)证实为肺动脉栓塞的患者溶栓前后MRI影像资料对比分析。结果 67例栓子位于肺叶或叶以上肺动脉，11例栓子位于肺动脉分叉部。双侧肺动脉栓塞51例，右侧23例，左侧4例。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(纤维成分为主合并钙化)。溶栓后完全再通58例，不完全再通16例，未再通4例，溶栓后硬栓子疗效显著差与软栓子(P<0.005)。结论 中心型PTE可通过中场强MRI影像作出准确诊断，肺血管成像(MRPP)为同时也周围型肺栓塞症的诊断提供了新方法，MRI有潜在的识别新旧血栓的能力，能清晰显示栓子的形态结构，栓子的形态结构与栓子的可溶性有相关性，能够对内科溶栓治疗效果进行预判，可作为除CT之外的另一选择。
【关键词】肺血栓栓塞症 MRI 诊断
中图分类号：R563.5 文献标识码：A 文章编号：1005-0515(2011)5-020-03
78 cases of pulmonary thromboembolism Clinical analysis of MRI examination
Wen Xianxia
(Eastern Hunan Normal University Affiliated Hospital, Hunan 412200)
【Abstract】Objective To evaluate MRI examination of pulmonary thromboembolism (PTE) of the diagnostic value. Methods 78 cases and pulmonary angiography (DSA) in patients with confirmed pulmonary embolism after thrombolytic therapy comparative analysis of MRI images. Results 67 patients with emboli in the pulmonary lobe or leaf above, 11 cases of pulmonary emboli at the bifurcation. Bilateral pulmonary embolism in 51 cases, 23 cases of right side, left side in 4 cases. MRI signal intensity according to the classification of emboli: A type of soft emboli (rich in water); B type is mixed emboli (emboli gradually machine of); C type for the hard peg (mainly fiber components calcification). Complete reperfusion after thrombolytic therapy in 58 cases, 16 cases of incomplete recanalization, no recanalization in 4 cases, thrombolytic emboli significant effect upon the hard and soft emboli difference (P <0.005). Conclusion Central-type PTE can be strong through the midfield MRI imaging is an accurate diagnosis, pulmonary angiography (MRPP) for the peripheral pulmonary embolism and also provides a new method for the diagnosis, MRI has the potential ability to identify new and old blood clots, can clearly show morphology of emboli, emboli and thrombi of the soluble form of structure is correlated to the effects of thrombolytic therapy on the medical pre-sentence, except as an alternative to CT.
【Key words】pulmonary embolism MRI diagnosis
肺动脉血栓栓塞症(PTE,即肺动脉栓塞，简称肺栓塞)是严重危害人民健康的常见心血管疾病 ......
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