Clinical application of intensified helical CT and pulmonary artery angiography in diagnosis and treatment of pulmonary embolism / 解放军医学杂志

ABSTRACT

Objective To evaluate the value of helical CT and pulmonary artery angiography in the diagnosis and treatment of pulmonary embolism. Methods The data of helical CT and pulmonary angiography of 18 cases of pulmonary embolism suspected by clinical diagnosis were analyzed retrospectively. Pulmonary embolism was diagnosed in 12 patients with pulmonary angiography, and treated by suction throngh cathether and local fibrinolysis. Results Embolism was found to involve 107 pulmonary artery branches in the 18 cases, including bilateral pulmonary lower lobes in 28.97%, left and right main pulmonary artery in 22.43%, lobar artery and segmental artery in 40.18%, and main pulmonary artery in 8.41%. The direct signs of helical CT and pulmonary angiography included partial filling defect, mural filling defect, central filling defect or so-called railway-track sign, and total occlusion. Secondary signs included enlargement of pulmonary artery trunk, local pulmonary digemia, pulmonary infarction and pleural effusion. 12 patients survived and showed clinical improvement with significant increase in PaO_2. Conclusion Helical CT is a noninvasive and effective method for the diagnosis of pulmonary embolism, while the pulmonary artery angiography is also an important tool in diagnosis and treatment of it.