肺动脉栓塞影像及诊疗研究进展

Advances in Imaging Diagnosis of Pulmonary Embolism

摘要: 肺动脉栓塞作为近年来发病率较高的一种心血管疾病，临床上具有较高病死率及误诊率，在国内外已经被列为重要的医疗保健问题之一，备受关注。近年来随着肺栓塞诊断意识和各种检查技术的提高，对肺栓塞的诊断和及时治疗例数已明显提高。特别是随着和各种计算机软件技术的不断发展和影像设备的不断更新，CT和MRI在PE临床诊疗的应用价值日趋明显。特别是64及以上高排螺旋(MSCTA) CTPA，它结合多平面重建等各种后处理技术能形成等于甚至超过许多经典血管造影图像，从而使其影像评估有了较大进展，本文通过查阅国内外文献阐述了肺栓塞的研究进展，包括发病机理及各种检查手段的优缺点以及病理临床表现，主要阐述CTPA作为无创条件下首选检查手段的最新进展和独有的特点及优势。对各项检查的优缺点和可行性以及合理性进行探讨，提高对肺血栓栓塞症的早期诊断水平，降低在临床中的误诊率和漏诊率，使患者得到及时诊治，同时简述各种治疗方法的临床应用价值，使患者能够选择适合的治疗方法，从而降低患者死亡率，提高其生活质量。

Abstract: In recent years, pulmonary embolism as a higher incidence of cardiovascular disease, with high mortality and clinical misdiagnosis rate, at home and abroad has been listed as one of the major health problems of concern in recent years. With the diagnosis of pulmonary embolism and raise awareness of various inspection techniques, diagnosis and timely treatment of several cases of pulmonary embolism has been significantly improved. Especially with the various computer soft-ware technology and the continuous development of imaging equipment and constantly updated, CT and MRI in diagnosing PE clinical diagnosis has become more evident. Especially high slice spiral 64 and above (MSCTA) CTPA, which combines multi-planar reconstruction and other post- processing techniques to form equal or exceed many of the classic angiographic image, the image so that it has made significant progress in the assessment, this article by referring to domestic foreign literature describes the research progress of pulmonary embolism, including the advantages and disadvantages as well as the clinical and pathological manifestations and pathogenesis of various examination methods, mainly on CTPA as the preferred means of non-invasive examination of the latest developments and conditions of the unique features and advantages. Advantages and disadvantages and feasibility of the various checks and rationality to explore, improve the early diagnosis of pulmonary thromboembolism, reducing the clinical misdiagnosis and missed diagnosis rate, so that patients receive timely treatment, while a variety of treatment outlined the clinical value of the method, so that patients can choose the appropriate treatment to reduce mortality and improve their quality of life.