Verschakelen J A, Vanwijck E, Bogaert J, Baert A L
Department of Radiology, University Hospitals K.U. Leuven, Belgium.
Radiology. 1993 Sep;188(3):847-50. doi: 10.1148/radiology.188.3.8351360.
When fast, nondynamic scanning techniques are used in combination with adequate intravenous injection of contrast material, good-quality images of the pulmonary artery (PA) can be obtained with routine computed tomography (CT). The purpose of this study was to evaluate PA filling defects detected on these CT scans. Twenty-two CT scans from 22 patients with PA filling defects were reviewed. A routine scanning technique was used. Thrombus was unilateral in 12 cases and bilateral in 10. All patients but one had a predisposition for pulmonary embolism (PE). However, only five patients underwent CT because there was a strong suspicion for PE. In 17 cases, PE was not the first choice of clinical diagnosis; in 13 cases, thrombus of the PA was not even considered. Diagnosis was confirmed in 11 patients with ventilation-perfusion scanning (n = 7), angiography (n = 3), and surgery (n = 1). In 11 patients, anticoagulation therapy was started without further diagnostic procedures. Diagnosis of thrombus of the PA is possible with routine nondynamic, contrast material-enhanced CT. Because PE is often unsuspected at clinical examination, every contrast-enhanced CT scan of the chest should be evaluated for the presence of filling defects in the PA.
当快速、非动态扫描技术与充分的静脉注射造影剂联合使用时，通过常规计算机断层扫描（CT）可获得肺动脉（PA）的高质量图像。本研究的目的是评估在这些CT扫描中检测到的PA充盈缺损。回顾了22例有PA充盈缺损患者的22份CT扫描。采用常规扫描技术。血栓单侧出现12例，双侧出现10例。除1例患者外，所有患者均有肺栓塞（PE）倾向。然而，只有5例患者因高度怀疑PE而接受CT检查。在17例中，PE并非临床诊断的首选；在13例中，甚至未考虑PA血栓。11例患者通过通气灌注扫描（n = 7）、血管造影（n = 3）和手术（n = 1）确诊。11例患者未进行进一步诊断程序即开始抗凝治疗。通过常规非动态、造影剂增强CT可以诊断PA血栓。由于临床检查时PE常未被怀疑，因此每次胸部增强CT扫描均应评估PA中充盈缺损的存在情况。
