不同剂量CT肺动脉成像评估肺动脉高压严重程度

Assessment of the severity of pulmonary hypertension by CT pulmonary artery imaging with different doses

目的:探讨不同剂量电子计算机断层扫描肺动脉成像(CTPA)对肺动脉高压(PH)严重程度的评估价值。方法:选取确诊为PH患者70例,根据随机数字表法将其分为常规组和小剂量组,每组各35例。常规组采用60~80 mL对比剂进行扫描,小剂量组采用35 mL对比剂进行扫描。比较两组平均肺动脉CT值、对比噪声比(CNR)、图像信噪比(SNR)、有效剂量(ED)及图像评分;不同剂量CTPA对PH严重程度诊断率;不同剂量CTPA对PH严重程度诊断效能。结果:与常规组比较,小剂量组CT值、CNR显著增高,ED显著降低,差异有统计学意义(P<0.05),两组SNR和图像评分比较差异无统计学意义(P>0.05);与常规组(80.00%)比较,小剂量组对PH严重程度的诊断率(91.43%)显著升高;与常规组比较,小剂量组CTPA诊断PH严重程度的灵敏度、特异性、准确度,阳性预测值、阴性预测值、ROC曲线下面积显著升高,差异有统计学意义(P<0.05)。结论:不同剂量CTPA对PH严重程度的评估价值有所差异,小剂量评估价值更高,能够显著提高诊断的CT值、CNR、准确率,对临床有着一定的参考价值。

Objective To explore the value of computed tomography pulmonary angiography(CTPA) with different doses in evaluating the severity of pulmonary hypertension(PH). Methods 70 patients diagnosed with PH were selected and divided into a control group(n=35) and a low-dose group(n=35) according to random number table method. In the control group,60-80 mL contrast media was used for scanning. In the low-dose group, 35 mL contrast media was used. The average pulmonary artery CT, contrast noise ratio(CNR), image signal noise ratio(SNR), effective dose(ED) and image score was compared between the two groups. The Effects of CTPA with different doses on the diagnostic rate of PH severity and its effects on the diagnostic efficacy of PH severity were also compared. Results Compared with the control group, the CT value and CNR of the low-dose group were significantly higher, the ED was significantly lower, and the differences were statistically significant(P<0.05). The differences in SNR and image scores between the two groups was not statistically significant(P>0.05). Compared with the control group(80.00%), the low-dose group had a significantly higher diagnosis rate(91.43%) for the severity of PH, Compared with the control group, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under ROC curve of the CTPA significantly increased in low-dose group when diagnosing the severity of PH, and the difference was statistically significant(P<0.05). Conclusion The value of CTPA with different does for the severity evaluation of PH is different. The value of small doses is higher, which can significantly improve the CT value, CNR and accuracy of diagnosis and has certain reference value for the clinic.