目的 分析多层螺旋CT肺动脉成 像对急诊肺动脉栓塞的临床诊断应用与价 值。方法 收集72例行多层螺旋CT或MRI检 查的肺动脉栓塞患者的病历与影像学资 料，行多层螺旋CT肺动脉成像的患者为CT 组(n=48)，行常规MRI血管造影的患者为 MRI组(n=24)，分析两组的影像学资料， 比较图像显示及诊断情况，并分析多层螺 旋CT肺动脉成像的特点。结果 与MRI组 相比，CT组诊断准确性91.67%、敏感性 70.83%、图像质量等级评分显著较高，扫 描时间明显较短(P＜0.05)；多层螺旋CT 检查诊断包括急性栓塞和慢性栓塞，栓塞 部位以双侧居多；病变范围包括左右肺动 脉远端、肺叶动脉、肺段以下动脉等；直 接征象为肺动脉或分支内充盈缺损；间接 征象表现为马赛克征、局限性肺纹理纤细 或稀疏、肺动脉高压或扩张、胸腔或心包 积液、部分肺段渗出或梗死。结论 多层 螺旋CT肺动脉成像在急诊肺动脉栓塞诊断 中具有准确性、敏感性高，图像质量好等 优点，且影像征象明显，对急诊肺动脉栓 塞的临床诊疗有重要价值。

Objective To analyze the clinical value of multi-slice spiral CT pulmonary angiography in the diagnosis and treatment of emergency pulmonary embolism. Methods The medical records and imaging data of 72 patients with pulmonary embolismwho underwent multi-slice spiral CT or MRI examination were collected. Patients undergoing spiral CT pulmonary angiography were included in CT group (n=48) while patients undergoing routine MRI angiography were included in MRI group (n=24). The imaging data of two groups were analyzed. The image display and diagnosis were compared, and the characteristics of multi-slice spiral CT pulmonary angiography were analyzed. Results Compared with the MRI group, the diagnostic accuracy (91.67%), sensitivity (70.83%) and image quality score in CT group were significantly higher, and the scanning time was shorter (P<0.05). Multislice spiral CT diagnosis included diagnosis of acute and chronic thrombosis, and the common site of embolism was bilateral. Extent of lesions included distal left and right pulmonary arteries, pulmonary lobar arteries, and pulmonary segment belowarteries, etc. The direct signs included filling defects of pulmonary artery or branches while indirect signs included mosaic sign, limited lung markings or sparse, pulmonary hypertension or expansion, pleural or pericardial effusion, and effusion or infarction of some pulmonary segments. Conclusion Multislice spiral CT pulmonary angiography is accurate in the diagnosis of emergency pulmonary embolism, with high sensitivity and good image quality, and the imaging signs are obvious, which is of important value in clinical diagnosis and treatment of emergency pulmonary embolism.