目的 研究多层螺旋CT(MSCT)图 像后处理技术在肺栓塞诊断中的应用价 值。方法 选取我院2015年1月-2016年1月 38例经CT肺血管成像(CTPA)确诊的肺栓塞 患者，采用MSCT对患者先行常规动脉增 强扫描，观察对肺动脉及栓子的显示效 果；采用MSCT图像后处理技术将所得扫 描图像进行多平面重组(MPR)、最大密度 投影(MIP)及容积再现(VR)处理，进一步 观察肺动脉各分支及栓子的显示效果，并 与单纯MSCT扫描结果比较。结果 38例肺 栓塞患者均成功完成检查，常规MSCT共 显示362支肺动脉分支受累，而经过图像 后处理后共发现385支肺动脉分支受累， 其中主肺动脉8支，左右肺动脉35支，肺 叶动脉78支，段动脉218支，亚段动脉46 支；经MPR、MIP、VR图像处理后，能较 为清晰的观察肺动脉分支充盈缺损及其 他征象；385支受累肺动脉分支中MPR显 示97.14%(374/385)高于MIP(362/385)、 VR92.73%(357/385)，差异具有统计学意 义(P<0.05)。结论 常规MSCT扫描后经过 图像后处理技术能进一步准确观察栓子和 肺动脉分支受累情况，通过征象表现对指 导临床诊断具有重要作用；MPR在亚段及 其以下肺动脉分支栓子的显示效果明显优 于MIP、VR。

Objective To study the application value of multi-slice spiral CT (MSCT) image postprocessing techniques in the diagnosis of pulmonary embolism (PE). Methods A total of 38 patients with PE diagnosed by CT pulmonary angiography (CTPA) in our hospital during January 2015 - January 2016 were enrolled in the study. All patients received conventional arterial enhancement scanning with MSCT, the display of pulmonary arteries and emboli was observed. The images obtained through MSCT image postprocessing techniques were treated with multiplanar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR), and the display of pulmonary arteries and emboli was observed again. The results were compared with those of pure MSCT scan. Results All subjects successfully completed the examination. Routine MSCT showed a total of 362 branches of pulmonary artery involvement, and image postprocessing showed a total of 385 branches of the pulmonary artery involvement, including 8 main pulmonary arteries, 35 left and right pulmonary arteries, 78 lobar arteries, 218 segmental arteries and 46 sub segmental arteries. After MPR, MIP and VR image processing, the branch filling defects and other signs of pulmonary artery can be observed clearly. Among 385 branches of pulmonary artery involvement, there were 97.14% (374/385) displayed by MPR, more than (362/385) by MIP and 92.73% (357/385) by VR (P<0.05). Conclusion After routine MSCT scanning, image postprocessing techniques can accurately display emboli and pulmonary artery involvement, and the signs play an important role in clinical diagnosis. The display of sub segmental and lower pulmonary artery emboli by MPR is better than MIP and VR.