双源CT在急性肺动脉栓塞严重程度及右心室功能变化评估中的应用

Application of Dual-source CT in the Assessment of the Severity of Acute Pulmonary Embolism and Changes of Right Ventricular Function

目的分析双源电子计算机断层扫描(DSCT)在急性肺动脉栓塞(APE)严重程度及右心室功能变化评估中的应用效果。方法回顾性分析我院68例APE患者临床资料,分别记录其DSCT肺动脉成像(CTPA)及双能量肺灌注成像(DEPI)检查情况。根据患者临床表现分为严重APE组及非严重APE组,比较两组血管阻塞指数、灌注缺损指数及右心室与左心室短轴最大径比(RV/LV)差异,并分析RV/LV与血管阻塞指数、灌注缺损指数的相关性。结果 68例APE患者中严重APE28例(41.18%),纳入严重APE组;非严重APE40例(58.82%),纳入非严重APE组。严重APE组血管阻塞指数、灌注缺损指数及RV/LV明显高于非严重APE组(P<0.05);经Pearson相关分析发现,RV/LV与血管阻塞指数、灌注缺损指数呈显著正相关(r=0.305、0.289,P<0.05)。结论 DSCT在评估APE严重程度及右心室功能中具有积极作用,临床使用价值较高。

Objective To analyze the application effects of dual-source computed tomography(DSCT) in the assessment of the severity of acute pulmonary embolism(APE) and changes of right ventricular function.Methods The clinical data of 68 patients with APE in our hospital were retrospectively analyzed.The DSCT pulmonary angiography(CTPA) and dual-energy pulmonary perfusion imaging(DEPI) were recorded.According to the clinical manifestations of patients,the patients were divided into severe APE group and non-severe APE group.The vascula r occlusion index,perfusion defect index and ratio of the right ventricle to the left ventricular short-axis(RV/LV) were compared between the two groups.The correlation between RV/LV and vascular obstruction index,perfusion defect index was analyzed.Results Among 68 patients with APE,there were 28 cases(41.18%) of severe APE and were included in the severe APE group,and there were 40 cases(58.82%) of non-severe APE and included in non-severe APE group.The vascular obstruction index,perfusion defect index,and RV/LV in the severe APE group were significantly higher than those in the non-severe APE group(P<0.05).Pea rson correlation analysis showed that RV/LV was significantly positively correlated with vascular occlusion index and perfusion defect index(r=0.305,0.289,P<0.05).Conclusion DSCT has positive effects in assessing the APE severity and right ventricular function,and it has a high clinical value.