目的探讨256层螺旋CT（iCT） 在肺动脉栓塞的诊断和溶栓效果评价的 应用价值。方法 分析33例肺动脉栓塞患 者的256层螺旋CT肺动脉造影资料，其中 18例溶栓治疗后复查。结果 本组33例患 者，共发现栓塞肺动脉215支，分别为肺 动脉干：左／右肺动脉：叶肺动脉：段 肺动脉支：亚段肺动脉=3:35：40:114： 23支。25例双侧肺动脉栓塞，8例仅单侧 肺动脉栓塞；18溶栓治疗后复查肺动脉血 管内充盈缺损均有不同程度缩小或消失。 结论 256层螺旋CT肺动脉造影能清晰显示 栓塞血管内血栓的形态、大小、范围，是 一种快速安全有效的检查方法，在PE的诊 断、指导治疗及判断疗效方面具有重要临 床应用价值。

Objective To Evaluation of diagnosis and thrombolysis effect on pulmonary embolism by 256 slice spiral computed Tomography. Methods 33 patients were analyzed with pulmonary embolism 256 slice spiral CT pulmonary angiography, including 18 cases who were reviewed after thrombolytic therapy. Results 215 embolism pulmonary artery were detected in the group of 33 patients.They located in respectively the pulmonary artery: left/right pulmonary artery: lobe pulmonary artery: period of pulmonary artery branch: the period of the pulmonary artery = 3:35:40:114-23. Meanwhile, there were 25 cases of bilateral pulmonary embolism, 8 cases of unilateral pulmonary embolism, and only 18 cases turned up the presence of pulmonary intravascular filling defect to dissolution or disappear in some extent after thrombolytic therapy. Conclusion MSCTA can be a kind of fast safe and effective inspection method to clearly show the shape, size and range which are formed by endovascular thrombosis embolism, and has important clinical value to diagnose of PE guiding treatment and judging curative effect.