急性肺栓塞致右心室功能不全的CT影像学分析

Analysis of coronary sinus in CT pulmonary angiography in patients with acute pulmonary embolism accompanied by right ventricular dysfunction

目的本研究旨在探讨急性肺栓塞(APE)致右心功能不全(RVD)患者CT影像学变化及其意义。方法回顾性分析解放军总医院2016年1月~12月经CT肺血管造影(CTPA)证实为肺栓塞并行右心导管检查确诊右心功能不全的患者26例为研究组,同时选取同期入院经CTPA排除的疑诊APE患者62例作为对照组,分析肺栓塞致右心功能不全患者CT影像学变化及其意义。结果研究组CTPA测量的RVd/LVd、冠状静脉窦直径明显大于对照组,差异有统计学意义(P<0.05)。结论在肺栓塞患者的临床诊断中,采用CTPA检查方式,同时测量RVd/LVd、冠状静脉窦直径,有助于在诊断肺栓塞的同时判断患者是否存在右心功能不全,为患者临床治疗提供指导。

Objective Right ventricular dysfunction （RVD） may occur in the course of acute pulmonary embolism （APE）. patients with RVD need more intensive treatment, and the prognosis is more severe. The aim of this study was to evaluate the usefulness of the measurement of CT pulmonary angiography in the assessment of RVD in patients with APE. Methods Retrospective analysis of our hospital since January 2016 to December 2016,26 patients who were confirmed pulmonary embolism by CT pulmonary angiography （CTPA）and right ventricular dysfunction by right heart catheterization were selected as the object of study, while 62 suspected APE patients who accepted CTPA however to be exclude pulmonary embolism were selected as a control group, and RVD was defined as PASP values greater than 30 mmHg. Results The RVd/LVd and diameter of the coronary sinus measured by CTPA in the study group was larger than that in the control group （P〈0.05）. Conclusion In the clinical diagnosis of the pulmonary embolism , The CTPA examination, combined with measuring the diameter of coronary sinus and RVd/LVd at the same time is very helpful to determining whether the presence of right ventricular dysfunction and clinical treatment procedure.