320排容积CT在急性大咯血介入栓塞术前应用及预测复发风险评估

Application of 320-DVCT in Preoperative Interventional Embolization of Acute Massive Hemoptysis and Prediction of Recurrence Risk Assessment

目的探讨320排容积CT血管成像在急性大咯血介入栓塞术前的指导作用及相关因素分析评估其复发风险。方法回顾性分析急性大咯血患者110例,同期行320排容积CT和DSA检查,分析CT在诊断咯血病因、责任血管准确率及两者检查一致性,并评估患者性别、年龄及各项异常CT征象等因素在咯血复发的预测价值。结果 CTA检出责任血管182支,检出率95.3%,与DSA检查结果一致性较高(Kappa值0.779,P<0.001),通过相关因素分析发现肺毁损、支气管动脉-肺动脉分流是咯血复发的危险因素,OR值分别为6.072、6.559。结论 320排容积CT对大咯血患者介入栓塞术前具有重要指导作用,大咯血伴有肺毁损和支气管动脉-肺动脉分流者复发风险高,需在栓塞术后定期随访或采取进一步干预措施。

Objective To explore the guiding role of 320-row dynamic volume CT angiography before interventional embolization of acute massive hemoptysis and analyze the related factors to evaluate its recurrence risk. Methods 110 patients with acute massive hemoptysis were analyzed retrospectively. They underwent 320-row dynamic volume CT and DSA examination at the same time. The accuracy of CT in diagnosing the etiology of hemoptysis,responsible vessels and the consistency of the two examinations were analyzed,and the predictive value of factors such as gender,age,abnormal CT signs in the recurrence of hemoptysis were analyzed. Results CTA detected 182 responsible vessels,and the detection rate reached 95. 3%. The results were consistent with DSA(Kappa value for 0. 779,P < 0. 001). Through the analysis on related factors,it was found that lung damage and bronchial artery pulmonary shunt were risk factors for recurrence of hemoptysis,and the OR values were 6. 072 and 6. 559. Conclusion 320-row dynamic volume CT plays an important role in guiding patients with massive hemoptysis before interventional embolization. Patients with massive hemoptysis accompanied by lung damage and bronchial artery pulmonary shunt have a high risk of recurrence,regular follow-up or Take further intervention methods should be conducted after embolization for further bleeding.