摘要
目的采用多层螺旋CT肺动脉造影(MSCTPA)评价急性肺栓塞与右心功能参数的相关性,评估急性肺栓塞患者的严重程度。方法采用非心电门控技术回顾性分析2012年1月-2013年11月间行多层螺旋CT肺动脉造影患者107例,其中肺栓塞组患者57例,对照组50例。采用CT后处理软件测量主肺动脉及胸主动脉内径比值(PA/AO)、右心室相关参数包括四腔心层面左右室短轴内径比(RVD/LVD)及截面积比(RVA/LVA)、横断面左右心室最大短轴内径比值(RV/LV-LD)。对中心死亡、中心存活、周围型肺栓塞及对照组之间右心功能各组参数进行比较。结果肺栓塞组右心室相关参数RVD/LVD、RV/LV-LD、RVA/LVA均明显大于对照组(P<0.05);而PA/AO于两组间无明显差异。肺栓塞组中中心死亡组与中心存活、周围、对照组的RVD/LVD、RV/LV-LD及RVA/LVA三项指标均存在统计学差异(P=0.000);中心存活与周围组的RVD/LVD、RVA/LVA两参数间有差异(P<0.05);而周围组与对照组的以上三项指标间均无明显差异(P>0.05)。对中心死亡组右心计量指标进行ROC曲线分析得出,RVA/LVA预测APE早期死亡准确性最佳(AUC=0.873),敏感性为100%,特异度为71.2%。结论多层螺旋CT肺动脉成像不仅能够准确诊断急性肺栓塞,还能客观评价右心室各相关参数,对评估肺动脉栓塞严重程度具有重要意义。
Objective To evaluate the correlation between acute pulmonary embolism（PE） and right cardiac function by multi-slice Spiral CT pulmonary angiography（MSCTPA）, and assess the severity of patients with acute pulmonary embolism. Methods A retrospective study including 107 cases MSCTPA data, of which 57 cases with PE, 50 cases without pulmonary embolism, from January 2012 to November 2013. Using CT postprocessing software measured thoracic aorta and main pulmonary artery inner diameter ratio（PA/AO）, right ventricular correlation parameter, including right ventricle diameter to left ventricle diameter ratio（RVD/LVD） and right ventricle area to left ventricle area ratio（RVA/LVA） on axial four-chamber（4-CH） sections and the largest of maximum minor axis diameters on axial sections（RV/LV-LD）. To compare the difference of CT related right heart parameter between the groups of central PE with death,central PE survivor, peripheral PE and the control group. Results There were significantly different between PE group and the control group with CT-related right ventricular parameters RVD/LVD,RV/LV-LD,RVA/LVA in PE group（P〈0.05）（excepting PA/AO）. Statistically significant differences were found in these measurements（RVD/LVD,RV/LV-LD,RVA/LVA）comparing patients with central PE with death and central PE survivors and those with peripheral PE and control group（P=0.000）. There were significantly different between central PE survivor and peripheral PE with CTrelated right ventricular parameters RVD/LVD, RVA/LVA, but there were no statistically significant differences between peripheral PE patients and the control group in all RV parameters. Analyze the cor dextrum measuring index ROC curve of central PE with death group, RVA/LVA is the best indicator of predicting early death（AUC=0.873）, with a sensitivity of 100%,specificity71.2%. Conclusion MSCTPA not only is able to accurately diagnose acute pulmonary embolism, but also is an objective evaluation of all relevant parameters of the right ventricle. Which plays an important role in assessing the severity degree of acute pulmonary embolism.
出处
《中国CT和MRI杂志》
2016年第11期50-53,共4页
Chinese Journal of CT and MRI
关键词
肺动脉栓塞
右心功能
多层螺旋CT
Pulmonary Embolism
Right Ventricular Function
Multi-slice Spiral CT
作者简介
通讯作者：李彩英
