目的探究多层螺旋CT(MSCT)结 合磁共振成像(MRI)对肺动脉栓塞的诊断 价值。方法 选择我院2015年2月至2017年 8月收治的经影像学检查确诊为肺动脉栓 塞的66例患者作为研究对象，所有患者均 行MSCT及MRI扫描，并经数字减影血管造 影(DSA)及病理诊断进行确诊，由两位影 像学医师对MSCT及MRI图像进行分析，比 较MSCT、MRI及MSCT联合MRI诊断肺动脉栓 塞的效果。结果 66例患者MSCT诊断显示 受累的肺动脉为145支，MRI诊断受累肺动 脉为137支，MSCT联合MRI诊断显示受累的 肺动脉为154支，其中直接征象为肺动脉 内不同程度的充盈缺损；间接征象包括马 赛克征、肺动脉高压、胸腔积液、脑梗 死等；以DSA及病理诊断结果为金标准， MSCT、MRI及MSCT联合MRI诊断的灵敏度分 别为92.94%、87.82%及98.71%，组间比较 差异显著(P<0.05)。结论 MSCT联合MRI对 肺动脉栓塞诊断效果显著优于单一MSCT及 MRI诊断，临床上可根据将其作为肺动脉 栓塞诊断的参考。

Objective To explore the value of multi-slice spiral CT (MSCT) combined with magnetic resonance imaging (MRI) in the diagnosis of pulmonary embolism. Methods A total of Sixty-six patients with pulmonary embolism diagnosed by imaging examination in the hospital from February 2015 to August 2017 were selected as the study subjects. All patients underwent MSCT and MRI scans, and digital subtraction angiography (DSA) was performed for confirmed diagnosis. Images of MSCT and MRI were analyzed by two imaging physicians. The effects of MSCT, MRI and MSCT combined with MRI in diagnosis of pulmonary embolism were compared. Results MSCT showed 145 involved pulmonary arteries while MRI showed 137 pulmonary arteries in 66 patients. MSCT combined with MRI showed 154 pulmonary arteries. The direct signs included different degrees of filling defects in pulmonary arteries, while indirect signs included mosaic sign, pulmonary hypertension, pleural effusion and cerebral infarction, etc.. With the diagnostic results of DSA as the golden standard, the diagnostic sensitivities of MSCT, MRI and MSCT combined with MRI were 92.94%, 87.82% and 98.71%, respectively (P<0.05). Conclusion MSCT combined with MRI is significantly better than single MSCT or MRT in the diagnosis of pulmonary embolism. It can be used as a reference for the diagnosis of pulmonary embolism.