128层CT肺血管成像对急性肺栓塞严重程度的评估

Assessment of the Severity of Acute Pulmonary Embolism by 128 Slice CT Pulmonary Angiography

目的:探讨128层CT肺血管成像(CTPA)在急性肺动脉栓塞严重程度评估中的价值。方法:选择行CTPA检查确诊的肺栓塞患者44例作为研究对象,按照CT肺动脉阻塞指数Mastora评分方法将患者分为轻、中、重度三组,在CT横断面上分别测量右心室(RV)、左心室(LV)最大短轴直径,主肺动脉(MPA)、升主动脉(AA)、上腔静脉(SVC)、奇静脉(AV)直径,并计算右心室最大短轴直径(RVd)与左心室最大短轴直径(LVd)之比及主肺动脉直径(MPAd)与升主动脉直径(AAd)比值;观察AV、下腔静脉(IVC)、肝静脉(HV)、冠状静脉(CV)等对比剂返流情况。结果:随着肺动脉阻塞指数增加,CT横断面RVd增大,LVd减小、RVd/LVd比值增加;SVC和AV扩张,AV、IVC、HV、CV对比剂反流更加明显;MPAd/AAd比值增加。结论:128层CTPA可辅助判断急性肺栓塞的严重程度,为临床选择治疗方法、判定预后及观察疗效提供必要的帮助。

Objective： To evaluate the value of 128 slice CT pulmonary angiography （ CTPA ） in the assessment of acute pulmonary embolism （APE） .Method： 44 pulmonary embolism patients with CTPA examination were selected as the research objects.According to the Mastora scoring method of CT pulmonary arterial obstruction index they were divided into the mild, the moderate and the severe group.On transverse CT images, The maximum short axis diameters of right ventricular （ RV ） and left ventrieular （ LV ）, the diameters of main pulmonary artery （ MPA ）, ascending aorta （ AA ）, superior vena cava （ SVC ） and azygos vein （ AV ） were measured.The ratio of the right ventricular maximum short axis diameter （ RVd ） and left ventrieular short axis diameter （ LVd ）, the ratio of main pulmonary artery diameter （ MPAd ） and ascending aortic diameter （ AAd ） were calculated.The situation of contrast agents regurgitation of azygos vein （ AV ）, inferior vena cava （ IVC ）, hepatic vein （ HV ） and coronary vein （ CV ） were observed.Result： With the increase of pulmonary arterial obstruction index, the RVd of CT was increased, the LVd was decreased and the ratio of RVd/LVd was increased. The SVC and AV ware expended.The situation of contrast agents regurgitation of AV, IVC, HV and CV was more obvious.The ratio of MPAd/AAd was increased.Conclusion： The 128 slice CTPA can help to judge the severity of acute pulmonary embolism and provide the necessary help for clinical choice of treatment, determination of prognosis and observation of efficacy.