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目的评价多层螺旋CT肺血管成像(MSCTPA)对肺动静脉畸形(PAVMs)的诊断价值。方法回顾性分析10例肺动静脉畸形的临床和MSCT表现。采用16层螺旋CT扫描仪,增强后分两期扫描,延迟时间分别为7～9s和21～23s。图像传后处理工作站进行血管重建,重建方法包括VR、MIP、MPR。结果CTA后处理血管重建可以显示供血动脉、畸形血管团、引流静脉,供血动脉的来源、引流静脉的去处也充分易显示。按病变形态与影像表现,肺动静脉畸形CT后处理表现分为三型:单纯型5例,复杂型2例,弥漫型3例。临床上单纯型均为体检发现,复杂型2例中1例体检发现,1例表现反复咯血;弥漫型3例患者均表现低氧血症。结论不同类型PAVMs,其临床表现、CT征象各异。MSCTPA可取代常规血管造影成为PAVMs的首选检查和诊断方法。
Objective To evaluate the diagnostic value of multislice CT pulmonary angiography (MSCTPA) for pulmonary arteriovenous malformations (PAVMs). Methods The clinical and MSCT findings of 10 pulmonary arteriovenous malformations were retrospectively analyzed. A 16-slice spiral CT scanner was used to enhance the scanning in two stages with delay times of 7-9s and 21-23s, respectively. Image post-processing workstation for vascular reconstruction, reconstruction methods include VR, MIP, MPR. Results CTA posterior revascularization can show the source of blood supply artery, abnormal blood vessels, drainage veins and feeding arteries, and the venous drainage can be easily displayed. According to the lesion morphology and imaging performance, CT posterior pulmonary arteriovenous malformations were divided into three types: simple type in 5 cases, complex type in 2 cases and diffuse type in 3 cases. Clinically pure type are physical examination found that 2 cases of complex in 1 case of physical examination found that 1 case showed repeated hemoptysis; diffuse 3 patients showed hypoxemia. Conclusion Different types of PAVMs have different clinical manifestations and CT signs. MSCTPA can replace routine angiography as the preferred method of examination and diagnosis of PAVMs.