探讨螺旋CT心胸比值在心衰的临床研究

Investigation of clinical research of spiral CT cardiothoracic ratio in heart failure

目的探讨螺旋CT心胸比值在心衰(心力衰竭)的临床诊断中的作用。方法收集110例心力衰竭患者螺旋CT胸部检查影像学资料进行回顾性分析,分析心胸比值测定在心衰患者中的诊断价值。结果螺旋CT心胸比值在0.50~0.55轻度增大患者50例,肺部纹理、血管及胸膜无异常,临床诊断心功能不全20例,占40%;螺旋CT心胸比值0.55~0.60中度增大患者38例,临床诊断心功能不全35例,占92%,同时肺纹理增粗、血管扩张及少量胸水;螺旋CT心胸比值0.60以上重度增大22例,临床诊断心功能不全22例,占100%,同时可观察肺淤血、心脏各房室大小、冠脉钙化及胸腔、心包积液。结论螺旋CT心胸比值在0.55以上患者与临床诊断较相符,可为临床诊断心衰提供一种新的判断手段,提高确诊的目的 ,为临床诊断、鉴别诊断提供新的途径。

Objective To investigate effect by spiral CT cardiothoracic ratio in clinical diagnosis of heart failure. Methods Imaging material of spiral CT chest examination for 110 patients with heart failure were collected for retrospective analysis, and diagnostic value by cardiothoracic ratio in heart failure patients was analyzed. Results Among 50 cases with mild increasing spiral CT cardiothoracic ratio as 0.50-0.55, there were 20 cases diagnosed as cardiac insufficiency, accounting for 40%, with normal lung texture, blood vessel and pleura. Among 38 cases with moderate increasing spiral CT cardiothoracic ratio as 0.55-0.60, there were 35 cases diagnosed as cardiac insufficiency, accounting for 92%, with thickening lung texture, angiectasis and few hydrothorax. Among 22 cases with severe increasing spiral CT cardiothoracic ratio over 0.60, there were 22 cases diagnosed as cardiac insufficiency, accounting for 100%, with pulmonary congestion, atrium and ventricle size, coronary artery calcification, pleural and pericardial effusion. Conclusion Patients with spiral CT cardiothoracic ratio over 0.55 showed corresponding outcome with clinical diagnosis, and this method can provide a new judgment measure for clinical diagnosis of heart failure to improve diagnosis outcome. It can provide a new pathway for clinical diagnosis and differential diagnosis.