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PULMONER TROMBOEMBOLİ TANISINDA SPİRAL BİLGİSAYARLI TOMOGRAFİ

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Abstract (2. Language): 
Spiral computed tomography in the diagnosis of pulmonary thromboembolism. Pulmonary embolism (PE) İs a common dİsease with hİgh morbidity and mortality. The aim of the study was to compare the accuracy of spiral computed tomography (CT) widı ventilation-perfusion scintigraphy for the diagnose of pulmonary embolism. Eighteen patients (9 female, 9 male, mean age 44.4±14.3 year) were İncluded. CT İmages for the patients were viewed at settings for pulmonary vasculature, lung parenchyma and pleural pathologies. The presence of clot in the main and segmental pulmonary arteries was observed in 7 (39%) patients. In 6 patients (33%), the İndirect sign of pulmonary thromboembolism, localized vasculary enlargement was observed. In pulmonary vessel, there were no clot sign in 5 patients (28%). Parenchymal infiltrates were seen togetlıer in 3 of them. Minimal pleural effuision was seen 13 patients (72%). Four of the 5 patients underwent CT scan in which did not have clot formatİon in pulmonary artery vasculature had mediai lobe parenchymal consolidatİon. Ventilation- perfusion lung seans were found as hİgh probabiüty in 10 patients. Clot formation findings on spiral CT were found in 7 patients (70%) with high probabity scintigraphic scan for pulmonary embolism. In addition, 6 of the 8 patients (75%) with low or moderate V/Q scan also had findings of clot fİndİngs on spiral CT. It was coneluded that, spiral CT and V/Q scintigraphy when combined havc sİgnifİcant value for diagnosing of acute PE.
Abstract (Original Language): 
Pulmoner emboli raortalite ve morbiditesi yüksek olan bir hastalıktır. Bu çalışmada, akut tromboemboli tanısında spiral toraks bilgisayarlı tomografi (BT) bulgularının, ventİlasyon perüzyon sintİgrafisi (V/Q) sonuçları ile karşılaştırılması amaçlandı. Çalışmaya 18 olgu (9 kadın, 9 erkek, ortalama yaş 44.4±14.3 yıl) alındı. Spiral BT bulguları, her bir olguda pulmoner arter, parankim ve plevraya ait patolojiler şeklinde ayrıldı. Yedi (%39) olguda pulmoner arter lob veya segment dallarında trombüs saptandı, 6 (%33) olguda İse trombüs olmaksızın puimoner arter dallarında genişleme görüldü. Beş olguda (%28) pulmoner arter dallarına ait patoloji görülmedi. Tüm olgularda konsolidasyon şeklinde parankim lezyonu görüldü ve 3 olguda buna lineer atelektazi eşlik etmekte idi. On üç oldguda (%72) minimal plevral efüzyon saptandı. Pulmoner arter lob veya segment dallarında patoloji olmayan 5 olgunun 4'ünde BT'deki parankim konsolidasyonu orta Iobda idi. Ventİlasyon perfüzyon sintİgrafisi 10 olguda yüksek olasılıklı idi. Yüksek olasdıklı sintigrafi bulguları olan olguların 7'sinde (%70) spiral BT'de trombüse ait bulgular mevcuttu. Ek olarak, orta veya düşük olasılıklı sintigrafi bulguları olan 8 olgunun 6'smda (%75) spiral BT'de trombüse ait bulgular belirlendi. Sonuç olarak, spiral toraks BT incelemesi, akut akciğer tromboembolisi tanısında, tek başına sintigrafİk değerlendirmeye katkı sağlamaktadır.
260-263

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