Author/Editor		Rainer, Saša; Benko, Davorin
Title		Spiralna CT preiskava pljučnih arterij v diagnostiki pljučne embolije
Translated title		Spiral CT in diagnosis of pulmonary embolism
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 5
Publication year		2000
Volume		str. 317-23
Language		slo
Abstract		Background. Pulmonary embolism (PE) has high mortality-rate but remains undiagnosed in many patients. Spiral CT of pulmonary arteries has increasingly important role in diagnostic work-up of patients with suspected PE. We present our initial experience with this modality. Patients and methods. Since 1998 we performed 20 examinations in 18 patients. Following the unenhanced CT scan of the thorax we performed contrast-enhanced spiral CT of pulmonary arteries from the level of aortic arch to 2cm below inferiorpulmonary veins. We used 5mm and 3mm collimation. Acquisition was performed using pitch 1:1.6 and 1:2; for reconstruction of the images we used pitch 1:0.5 and 1:1. Using power injector, we administered 70 and 90ml of non-ionic contrast medium with concentration of 300 mg/ml. Flowrate was 3-4 ml/sec with peripheral venous access and 2.5 ml/ sec with injection through central venous line. The delay between injection and the start of spiral acquisition was judged empirically. Results. Signs of PE were demonstrated in 11 patients (61.1%); in one patient we performed two examinations in the interval of 8 months - both were positive for PE. In 6 patients (33.3 %), there were no signs of PE to the level of segmental arteries. 5 examinations (25%) were technicaly suboptimal, mainly due to inadequate opacification of pulmonary arteries and/or patient motion. In one patient the examination was repeated (the second study proved to be negative for PE); in the four remaining patients it was possible to demonstrate central and lobar emboli in two cases; in other two we could confidentely exclude only central and lobar PE. Additional findings were as common in patients with and without PE, pleural effusion was the most common finding in both groups of patients. Conclusions. (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Pljučna embolija (PE) je bolezen z visoko smrtnostjo, vendar pa mnogokrat ostane neprepoznana. Med slikovnimi metodami v diagnostiki PE ima vse pomembnejše mesto spiralna CT preiskava pljučnih arterij. Posredujemo naše začetne izkušnje s to metodo v diagnostični obdelavi bolnikov s sumom na PE. Bolniki in metode. V obdobju od uvedbe preiskave leta 1998 smo opravili 20 preiskav pri 78 bolnikih. Po predhodni nativni CT preiskavi prsnega koša smo s kontrastno spiralno preiskavo prikazali področje od višine arkusa aorte do 2 cm pod ravnijo vpliva spodnjih pljučnih ven. Z rezi debeline 5mm in 3mm smo pri akviziciji uporabljali razmerje s pomikom mize (pitch) 1 : 1,6 in 1 : 2, pri rekonstrukciji pa 1 : 0,5 in 1 : 1. 70 in 90ml neionskega kontrastrtega sredstva s koncentracijo 300 mg/ml smo vbrizgali z injektorjem. Hitrost pretoka skozi periferni venski kanal je bila 3-4 ml/sec, skozi centralni venski kateter pa 2, 5 ml/sec. Interval med začetkom injiciranja in pričetkom spiralne akvizicije smo določili empirično. Rezultati. PE smo dokazali v 11 primerih (61,1%). Pri eni bolnici smo preiskavo opravili dvakrat v presledku 8 mesecev; obe preiskavi sta bili pozitivni za PE. Pri 6 bolnikih (33,3%) je bil izvid preiskave negativen. Tehnično neoptimalnih je bilo 5 preiskav (25%), večinoma zaradi nezadostne opacifikacije arterij in/ali gibalnih artefaktov. Izmed teh smo eno ponovili (ponovljena preiskava je bila negativna), pri dveh je bila možna diagnoza centralne ali lobarne PE, pri dveh pa smo lahko izključili le prisotnost centralne ali lobarne PE. Sočasne spremembe v pljučih so bile enako pogoste pri bolnikih s PE kot pri tistih brez PE; pri obeh je bil najpogostejši plevralni izliv. (Izvleček prekinjen pri 2000 znakih).
Descriptors		PULMONARY EMBOLISM TOMOGRAPHY, X-RAY COMPUTED PULMONARY ARTERY