胸部HRCT在早期左心室舒张功能不全诊断中的应用价值

Value of application of chest HRCT in the diagnosis of the early left ventricular diastolic dysfunction

目的:探讨胸部HRCT在诊断早期左心舒张功能不全的临床价值。方法:收治早期左心舒张功能不全患者52例,进行胸部HRCT检查,对肺小叶结构主要影像表现出现频率进行分析,分析早期左心舒张功能不全与肺小叶结构变化的相关性。结果:肺小叶Ⅰ级征象表现为胸膜下弧线影频率9例(17.3%),小叶密度增高频率2例(3.8%),小叶中心A频率16例(30.8%),小叶间隔增厚频率1例(1.9%);肺小叶Ⅱ级征象表现为显示胸膜下弧线影频率10例(38.5%),小叶密度增高频率18例(34.6%),小叶中心A频率23例(44.2%),小叶间隔增厚频率21例(46.2%);肺小叶Ⅲ级征象表现为胸膜下弧线影频率12例(23.1%),小叶密度增高频率23例(44.2%),小叶中心A频率12例(23.1%),小叶间隔增厚频率24例(46.2%);肺小叶Ⅳ级征象表现为胸膜下弧线影频率11例(19.2.%),小叶密度增高频率9例(17.3%),小叶中心A频率1例(1.9%),小叶间隔增厚频率6例(11.5%)。结论:胸部HRCT肺小叶的主要征象能充分反映肺静脉压升高、肺瘀血、间质性肺水肿及肺泡性肺水肿等早期左心舒张功能不全的病理变化,对提示早期左心舒张功能不全具有重要的临床意义。

Objective:To explore the value of application of chest HRCT in the diagnosis of the early left ventricular diastolic dysfunction.Methods:52 cases with early left ventricular diastolic dysfunction were selected.They underwent chest HRCT scan.We analyzed the frequency of occurrence of main manifestations of lung lobules structure,and the relevance between early left ventricular diastolic dysfunction with pulmonary lobule structure changes.Results:In the pulmonary lobule Ⅰ signs,9cases(17.3%) were subpleural lines video frequency,2 cases(3.8%) were lobular density increased frequency,16 cases(30.8%)were lobular center A frequency,1 case(1.9%) was interlobular septal thickening frequency.In the pulmonary lobule Ⅱ signs,10cases(38.5%) were subpleural lines video frequency,18 cases(34.6%) were lobular density increased frequency,23 cases(44.2%)were lobular center A frequency,21 cases(46.2%) were interlobular septal thickening frequency.In the pulmonary lobule Ⅲ signs,12 cases(23.1%) were subpleural lines video frequency,23 cases(44.2%) were lobular density increased frequency,12cases(23.1%) were lobular center A frequency,24 cases(46.2%) were interlobular septal thickening frequency.In the pulmonary lobule Ⅳ signs,11 cases(19.2.%) were subpleural lines video frequency,9 cases(44.2%) were lobular density increased frequency,1 case(1.9%) was lobular center A frequency,6 cases(11.5%) were interlobular septal thickening frequency.Conclusion:The main findings of pulmonary lobules in chest HRCT can reflect the pathological changes of early left ventricular diastolic dysfunction,such as pulmonary venous pressure,pulmonary congestion,pulmonary interstitial edema and alveolar pulmonary edema and so on.It has important clinical significance in prompting the early left ventricular diastolic dysfunction.