Nakahara Y, Kawashima M, Fujisawa N, Naitoh K, Akashi S, Hayashi S
Department of Internal Medicine, Saga Medical School, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Mar;35(3):300-5.
Pulmonary thromboembolism (PTE) was diagnosed in 22 patients at Saga Medical School between 1981 and 1994. Enhanced computed tomography (CT) was done in 8 patients, and filling defects in the central pulmonary artery were identified in 6. Parenchymal shadows (wedge shaped shadows, subpleural consolidation, or nodular shadow's) were noted in 5. When enhanced CT was done during acute severe respiratory failure in 3 patients, pulmonary artery filling defects were found in all. These findings suggest that enhanced CT is useful as a diagnostic tool for acute PTE with respiratory failure. Electron beam CT may be a sensitive and specific means of diagnosing PTE because it can be done quickly and without breath-holding. We conclude that enhanced CT should be used as the first diagnostic procedure in patients with severe respiratory failure who may have PTE.
1981年至1994年间，佐贺医科大学诊断出22例肺血栓栓塞症（PTE）患者。8例患者进行了增强计算机断层扫描（CT），其中6例发现中央肺动脉充盈缺损。5例患者出现实质阴影（楔形阴影、胸膜下实变或结节状阴影）。3例急性严重呼吸衰竭患者在进行增强CT检查时，均发现肺动脉充盈缺损。这些发现表明，增强CT对于诊断伴有呼吸衰竭的急性PTE是一种有用的诊断工具。电子束CT可能是诊断PTE的一种敏感且特异的方法，因为它可以快速完成且无需屏气。我们得出结论，对于可能患有PTE的严重呼吸衰竭患者，应将增强CT作为首要诊断程序。
