【摘要】：目的 采用多層螺旋CT肺動(dòng)脈造影(MSCTPA)評(píng)價(jià)急性肺栓塞與右心功能參數(shù)的相關(guān)性,評(píng)估急性肺栓塞患者的嚴(yán)重程度。方法 采用非心電門(mén)控技術(shù)回顧性分析2012年1月-2013年11月間行多層螺旋CT肺動(dòng)脈造影患者107例,其中肺栓塞組患者57例,對(duì)照組50例。采用CT后處理軟件測(cè)量主肺動(dòng)脈及胸主動(dòng)脈內(nèi)徑比值(PA/AO)、右心室相關(guān)參數(shù)包括四腔心層面左右室短軸內(nèi)徑比(RVD/LVD)及截面積比(RVA/LVA)、橫斷面左右心室最大短軸內(nèi)徑比值(RV/LV-LD)。對(duì)中心死亡、中心存活、周?chē)头嗡ㄈ皩?duì)照組之間右心功能各組參數(shù)進(jìn)行比較。結(jié)果 肺栓塞組右心室相關(guān)參數(shù)RVD/LVD、RV/LV-LD、RVA/LVA均明顯大于對(duì)照組(P0.05);而PA/AO于兩組間無(wú)明顯差異。肺栓塞組中中心死亡組與中心存活、周?chē)�、�?duì)照組的RVD/LVD、RV/LV-LD及RVA/LVA三項(xiàng)指標(biāo)均存在統(tǒng)計(jì)學(xué)差異(P=0.000);中心存活與周?chē)M的RVD/LVD、RVA/LVA兩參數(shù)間有差異(P0.05);而周?chē)M與對(duì)照組的以上三項(xiàng)指標(biāo)間均無(wú)明顯差異(P0.05)。對(duì)中心死亡組右心計(jì)量指標(biāo)進(jìn)行ROC曲線分析得出,RVA/LVA預(yù)測(cè)APE早期死亡準(zhǔn)確性最佳(AUC=0.873),敏感性為100%,特異度為71.2%。結(jié)論 多層螺旋CT肺動(dòng)脈成像不僅能夠準(zhǔn)確診斷急性肺栓塞,還能客觀評(píng)價(jià)右心室各相關(guān)參數(shù),對(duì)評(píng)估肺動(dòng)脈栓塞嚴(yán)重程度具有重要意義。
[Abstract]:Objective to evaluate the correlation between acute pulmonary embolism and right ventricular function parameters by multi-slice spiral CT pulmonary angiography (MSCTPA), and to evaluate the severity of acute pulmonary embolism. Methods from January 2012 to November 2013, 107 patients underwent multi-slice spiral CT pulmonary angiography were analyzed by non-ECG gating technique, including 57 patients in pulmonary embolism group and 50 patients in control group. The ratio of main pulmonary artery to thoracic aortic diameter (PA/AO) was measured by CT post-processing software. The related parameters of right ventricle included left and right ventricular short axis ratio (RVD/LVD) and cross section area ratio (RVA/LVA). The ratio of maximum short axis diameter of left and right ventricle (RV/LV-LD). The parameters of right ventricular function were compared between central death, central survival, peripheral pulmonary embolism and control group. Results the RVD/LVD,RV/LV-LD,RVA/LVA of right ventricle in pulmonary embolism group was significantly higher than that in control group (P 0.05), but there was no significant difference in PA/AO between the two groups. There were significant differences in RVD/LVD,RV/LV-LD and RVA/LVA between the central death group and the center in the pulmonary embolism group and around the control group (P 鈮，

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