高原性肺水肿治疗前后胸部MSCT的对比研究

Comparative Study of Chest MSCT before and after Treatment for High Altitude Pulmonary Edema

目的 探讨胸部多层螺旋CT(MSCT)在高原肺水肿(HAPE)治疗前后对比中的应用。方法 收集2019年01月至2022年10月诊断为HAPE的胸部MSCT及临床资料50例。在胸部CT上对HAPE进行评分(S_(HAPE))。治疗前后分别测量主肺动脉(MPA)及同层面升主动脉(AA)、降主动脉(DA)直径,计算MPA与AA、DA比值,比较其差异。结果 治疗前MPA直径(3.18±0.38)cm,治疗后MPA直径(2.83±0.42)cm,治疗后MPA直径较治疗前明显缩小,差异有统计学意义(P<0.05),治疗前后MPA与AA、 DA比值差异有统计学意义(P<0.05)。HAPE治疗前S_(HAPE)为11.62±3.57,治疗后S_(HAPE)为6.12±4.22,差异有统计学意义(t=10.978,P=0.00)。治疗前、后的S_(HAPE)右肺大于左肺,比较均有统计学差异(P<0.05)。结论 HAPE表现为右肺病变重于左肺,合并MPA增宽,治疗后肺内病变减少伴MPA直径缩小。MSCT可用于HAPE治疗前后的评估。

Objective To investigate the application value of chest multislice spiral CT(MSCT) in the comparison before and after treatment of high altitude pulmonary edema(HAPE).Methoods 50 Chest MSCT and clinical data with the diagnosis of HAPE from January 2019 to October 2022 were collected.HAPE was scored(S_(HAPE)) in chest CT images according to the severity of pulmonary edema.The diameters of the main pulmonary a rtery(MPA),ascending aorta(AA) and descending aorta(DA) at the same level were measured in chest MSCT before and after HAPE treatment.The ratios of the MPA to AA and DA were calculated,and the differences were compared.Results Before treatment the diameter of the MPA was(3.18±0.38)cm.After treatment the diameter of the MPA was(2.83±0.42)cm.The diameter of the MPA was significantly reduced after treatment compared with that before treatment,with statistical significance(P<0.05).The re were statistically significant differences in the ratio of HAPE patients to the MPA,AA and DA before and after treatment(P<0.05).S_(HAPE) of HAPE was 11.62±3.57 before treatment and 6.12±4.22 after treatment,and the difference was statistically significant(t=10.978,P=0.00).The S_(HAPE) of the right lung before and after treatment was greater than that of the left lung,and the difference was statistically significant(P<0.05).Conclusion HAPE chest MSCT showed the lesions of the right lung were more serious than those of the left lung,combined with widening of the MPA.After treatment,the lesions in the lungs were reduced and absorbed in the chest MSCT,accompanied by a reduction in the diameter of the MPA.MSCT can be used in the evaluation of HAPE before and after treatment.