Fred Herbert L
Tex Heart Inst J. 2013;40(1):9-12.
The multidetector computed tomographic scanner has greatly improved our ability to quickly, safely, and adequately visualize the pulmonary arteries down to and including the subsegmental branches. But this sophisticated machine has also created new problems for clinicians who must care for patients who have what we now variously call incidental, asymptomatic, or unsuspected pulmonary thromboemboli—emboli that are clinically silent and detected unexpectedly. At this stage of our knowledge, we can say with certainty that these thromboemboli are common in all parts of the pulmonary arterial tree, are most often found in patients with cancer, carry a poor prognosis for patients with cancer, and are frequently missed during the initial CT reading. Their natural history and optimal management await definitive studies.
多层螺旋计算机断层扫描仪极大地提高了我们快速、安全且充分地观察肺动脉直至亚段分支的能力。但这一精密仪器也给临床医生带来了新问题，这些医生需要照料患有我们现在称之为偶然、无症状或未被怀疑的肺血栓栓塞症的患者，即临床上无明显症状且意外发现的栓子。就我们目前的认知水平而言，可以肯定地说，这些血栓栓塞在肺动脉树的各个部位都很常见，最常出现在癌症患者中，对癌症患者预后不佳，而且在最初的CT阅片中常常被漏诊。它们的自然病史和最佳治疗方案有待进一步明确研究。
