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The Diagnostic Assessment of Multi-slice Spiral CT with Plasma D-dimer Assay in the Diagnosis of Pulmonary Embolism

石士奎^*　程敬亮^*　杨运俊^#　赵艺蕾^*　陈伟建^#　刘海峰^※

^＊郑州大学第一附属医院放射科磁共振室，郑州 450052

^＃温州医学院附属第一医院放射科，温州 325000

^※温州医学院附属第一医院急诊内科，温州 325000

Shi－kui Shi^*，Jing－liang Cheng^*，Yun－jun Yang^#，Yi－lei Zhao^*，Wei－jian Chen^#，Hai－feng Liu^※

^*Department of Radiology，the First Affiliated Hospital，Zhengzhou University，Zhengzhou　450052，China

^#Department of Radiology，the First Affiliated Hospital，Wenzhou Medical College，Wenzhou 325000，China

^※Department of Emergency，the First Affiliated Hospital，Wenzhou Medical College，Wenzhou 325000，China

ABSTRACT

　　Objective：To investigate the diagnostic assessment of multi－slice spiral CT with plasma D－dimer assay in the diagnosis of pulmonary embolism.

　　Methods：48 suspected pulmonary embolism patients underwent both multi－slice spiral CT and plasma D－dimer assay，and the diagnostic values of MSCTPA the plasma D－dimer assay and the combination of MSCTPA and the plasma D－dimer assay were evaluated respectively. 22 patients of them underwent thrombolytic treatment after positive MSCTPA，and were performed with another more plasma D－dimer assays within 2th day，3th day，7th day and fortnight respectively，and another reexamination of MSCTPA within two weeks.

　　Results：The plasma D－dimer assays were all positive（48 cases），the positive rate was 100％；45 patients were interpreted as PE by MSCTPA，and 3 patients without apparent filling defect expression. One suspicious PE patient was confirmed by later thinner－slice reconstruction of 0.625mm on account of positive D－dimer assay. Among 22 patients reexaminated by D－dimer assay，the values of D－dimer assay of 13 patients increased within one week and decreased one week later，while the other 9 patients revealed no evident change.The area of filling defect of the former 13 patients became smaller，the latter 9 patients without obvious change on reexamniation of MSCTPA.

　　Conclusion：The combination of MSCTPA and plasma D－dimer assay can enhance the detecting rate of PE，and has significant value in diagnosing pulmonary embolism.

　　Key words：Pulmonary embolism；Thrombus；D－dimer；Tomography，X－ray；Computed