64排CT评估肺动脉栓塞严重程度的价值

Evaluation of the Severity of Pulmonary Embolism Using 64-row CT

目的:探讨64排螺旋CT定量评估肺动脉栓塞(PE)严重程度的价值。材料和方法:根据临床的严重性和治疗方法的选择,将95例怀疑PE的患者分为3组:严重肺动脉栓塞(SPE)组、非严重肺动脉栓塞(NSPE)组、无肺动脉栓塞(WPE)组。分别阅读各组的CTPA图像,采用CT动脉阻塞指数定量分析栓塞肺动脉的范围及程度,测量舒张期左、右心室短轴最大径及中央肺动脉直径,并观察室间隔形态。结果:与肺动脉严重程度显著相关的因素有:血管阻塞指数(SPE组:74.7;NSPE组:23.0;WPE组:0)、左室短轴最大径(SPE组:31.2mm;NSPE组:35.3mm;WPE组:36.6mm)、右室/左室短轴比(SPE组:1.24;NSPE组:1.04;WPE组:0.93)、中央肺动脉直径(SPE组:31.8mm;NSPE组:28.1mm;WPE组:25.9mm)和1、2级室间隔(SPE组:53.3%,13.3%;NSPE组:16.3%,0%)。结论:64排螺旋CT不仅能正确诊断可疑的PE,而且能定量评估PE的严重程度,从而为临床治疗提供更多的信息。

Purpose： To evaluate the severity of pulmonary embolism （PE） quantificationally using 64-row CT . Materials and Methods： Ninety-five patients with clinical suspicion of PE were divided into three different groups according to clinical severity and treatment decisions： severe PE （SPE） , non-severe PE （NSPE） and without PE （WPE）. After reading CTPA images of each groups, the vascular obstruction index was quantificationally analyzed based on the range and degree of obstruction in the pulmonary artery, measured the maximum short axes of left and right ventricles and diameter of central pulmonary artery in diastolic phase, observed the morphology of interventricular septum. Results： Factors significantly correlated with the severity of PE were the vascular obstruction index with 74.7 in SPE group, 23.0 in NSPE group and 0 in NSPE group （ P 〈 0. 001 ） ; the maximum short axis of left ventricle were 31.2mm in SPE group and 35.3mm in NSPE group （ P 〈 0.05 ）, 36.6mm in WPE group ; the right ventricle/ left ventricle short axis ratio were 1.24 in SPE group and 1.04 in NSPE group （ P 〈 0.05 ）, 0.93 in WPE group ; the diameter of central pulmonary artery were 31.8mm in SPE group ,28. lmm in NSPE group and 25.9mm in PE group （P 〈0.01 ） ; the interventricular septum of grade 1 and 2 were 53.3% and 13.3% versus 16.3% and 0% in SPE versus NSPE groups （P 〈 0. 001 ）. Conclusion： 64-row CT not only identifies suspected PE correctly, but evaluates the severity of PE, offers more information for clinical treatment.