中心型慢性肺动脉血栓栓塞的增强MR特征及其临床应用价值

目的探讨中心型慢性肺动脉血栓栓塞(CPTE)的增强MR影像特征与肺血管阻力(PVR)的关系。方法回顾性收集首都医科大学附属北京朝阳医院2018年1月至2020年12月诊治的, 且进行增强MR检查的中心型CPTE患者共39例, 评估其肺动脉影像学特征。根据其中33例患者的右心导管数据, 以PVR=1 000 dyn·s·cm^(-5)为阈值分为两组, 比较两组间增强MR影像特征差异, 并以性别、年龄、病程、胸膜增厚、双侧支气管扩张、受累血管节段数、血栓数及血栓部位管壁延迟强化节段数为自变量进行二分类logistics回归分析。结果 39例中心型CPTE患者受累肺动脉多表现为管腔扩张(168段, 43.30%)以及管壁延迟强化(122段, 31.52%)。血栓处动脉以管腔扩张发生率最高(66段, 52.80%)。PVR<1 000 dyn·s·cm^(-5)组的血栓多于PVR≥1 000 dyn·s·cm^(-5)组(χ^(2)=9.55, P=0.002), 血栓部位管壁延迟强化发生率在两组间差异无统计学意义(χ^(2)=0.90, P=0.344)。PVR<1 000 dyn·s·cm^(-5)组双侧支气管动脉扩张发生率高于PVR≥1 000 dyn·s·cm^(-5)组(P=0.019)。Logistic回归分析结果表明女性、较少受累血管节段数及双侧支气管动脉扩张与较低PVR相关。结论增强MRI有助于精准评估中心型CPTE患者肺动脉管腔异常和管壁重构情况, 这对于病情及疗效评估具有重要的意义。

Analysis of clinical and imaging features of Behcet's disease-related pulmonary lesions:a series of eight cases

To the Editor:Behcet's disease is a chronic vascular inflammatory disease that involves multiple systems of the body.Although the incidence of pulmonary damages is low in Behcet's disease,most of them are serious.The initial pulmonary damages of Behcet's disease are mainly manifested with mild cough,chest pain,and slight hemoptysis,which are easily misdiagnosed as pulmonary embolism,pneumonia,or other diseases.