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目的建立兔的慢性肺小动脉血栓栓塞模型,研究其64层CT肺动脉造影(CTPA)表现和诊断价值。材料与方法健康家兔8只,体重2.0～2.5kg。对栓塞前、后肺动脉造影和CT表现进行对比。栓塞组兔肺动脉多次注入经热处理的自体血栓,血栓直径1～2mm,长3～5mm,栓塞前、后和12周时行64层螺旋CT平扫和CTPA,分析其影像学表现特点。结果 8只兔对比栓塞前后CTPA影像发现栓塞血管共43支,其中血管直径为1.5～2.0mm7支,1.0～1.5mm8支,0.5～1.0mm共17支,<0.5mm者共11支。未对比栓塞前影像共发现直径<2.0mm的肺动脉栓塞31支,其中血管直径1.5～2.0mm7支(阳性率100%),1.0～1.5mm7支(阳性率87.5%),0.5～1.0mm12支(阳性率70.6%),<0.5mm5支(阳性率45.5%)。假栓塞组术前、后和12周以后CTPA均未发现肺动脉栓塞直接和间接征像。结论兔自体血栓反复注射法建立慢性肺小动脉栓塞模型有较高的可行性。64层螺旋CTPA对直径1mm以上级别的肺小动脉栓塞诊断阳性率高。
Objective To establish a model of chronic pulmonary arterial thromboembolism in rabbits and to study the performance and diagnostic value of 64-slice CT pulmonary angiography (CTPA). Materials and Methods 8 healthy rabbits, weighing 2.0 ~ 2.5kg. Before and after embolization of pulmonary angiography and CT performance comparison. Embolization group was infused repeatedly with heat-treated autologous thrombus. The thrombus diameter was 1 ~ 2mm and length was 3 ~ 5mm. Sixty-four-slice spiral CT and CTPA before and after embolization were performed. The imaging features were analyzed. Results There were 43 embolized blood vessels in CTPA images of 8 rabbits before and after embolization. Among them, there were 17 vessels of 1.5-2.0 mm in diameter, 8 vessels of 1.0-1.5 mm in diameter, 17 vessels of 0.5-1.0 mm in total and 11 vessels of <0.5 mm in diameter. Thirty-two pulmonary embolisms with diameter <2.0 mm were found in the non-contrast pre-embolization images, of which, the diameters of the vessels were 1.5-2.0 mm7 (positive rate 100%), 1.0-1.5 mm7 (positive rate 87.5%) and 0.5-1.0 mm2 Positive rate 70.6%), <0.5mm5 branch (positive rate 45.5%). There was no direct or indirect pulmonary embolism sign in CTPA before, after and 12 weeks after embolization. Conclusion The establishment of chronic pulmonary arterial embolization model by repeated injection of autologous thrombus in rabbit is more feasible. The 64-slice spiral CTPA has a high positive rate of diagnosing pulmonary arterial embolism with the diameter above 1mm.