目的:比较能谱CT碘基物质图与CTPA对检出肺段以下动脉栓子的应用对比。方法:利用能谱CT物质分离技术对32例肺段以下肺动脉栓塞患者进行能谱C T血管造影检查。通过容积数据在后处理工作站上利用碘水分离技术重建出碘基物质图及CTPA图(包...目的:比较能谱CT碘基物质图与CTPA对检出肺段以下动脉栓子的应用对比。方法:利用能谱CT物质分离技术对32例肺段以下肺动脉栓塞患者进行能谱C T血管造影检查。通过容积数据在后处理工作站上利用碘水分离技术重建出碘基物质图及CTPA图(包括MPR、MIP及VRT),根据碘基物质图上碘含量减低区对应查找肺栓塞栓子数量,与C T P A图上所发现的栓子数量进行对比,利用统计学软件进行统计分析两者之间的差异。结果:32例肺栓塞患者中碘基图上按段及亚段以下血管分布区共发现72个碘含量减低区(直接发现栓子共65个,只发现碘含量减低区的间接栓子7个);而在CTPA图上直接显示栓子45个;通过碘基图和CTPA联合观察共发现栓子75个。利用配对T检验,发现碘基图与CTPA图两组之间以及两组联合应用与CTPA之间的比较有统计学意义(P<0.05);而碘基图和碘基图与CTPA图联合应用两者之间无统计学差异(P>0.05)。结论:能谱C T碘基物质图对肺段以下肺动脉栓塞患者的栓子检出率优于CTPA,两者联合应用可明显提高肺段以下肺动脉栓塞的栓子检出率。展开更多
Objective. To investigate the high risk factors, clinical features, diagnosis and treatment of pulmonary embolism (PE) during pregnancy and the postpartum period.Methods. Two cases of PE during pregnancy and postpartu...Objective. To investigate the high risk factors, clinical features, diagnosis and treatment of pulmonary embolism (PE) during pregnancy and the postpartum period.Methods. Two cases of PE during pregnancy and postpartum period were reported retrospectively.Results. The first case was a pregnant woman with congenital heart disease at 39-week gestation. She underwent a successful cesarean section (CS) because of heart disease, but she manifested tachycardia, tachypnea, cyanosis, and dyspnea suddenly on the 10th day after CS and died soon after the onset of these symptoms. The diagnosis of PE was highly suspected clinically. The second case was a twin-pregnancy woman at 35-week gestation. Because of severe perinatal myocardiopathy, cesarean section was performed. Unfortunately, the patient died abruptly on the operation table. The diagnosis of PE was confirmed by autopsy.Conclusions. The maternal mortality of PE during pregnancy and postpartum period is quite high. Whenever there is any doubt, objective examinations for PE should be started early in order to strive for the chances of the anticoagulant therapy.展开更多
This article discusses the mechanism, diagnosis, and treatment of a case of double pulmonary embolism and left common iliac vein thrombosis following in vitro fertilization （IVF） and embryo transfer （ET） to arouse...This article discusses the mechanism, diagnosis, and treatment of a case of double pulmonary embolism and left common iliac vein thrombosis following in vitro fertilization （IVF） and embryo transfer （ET） to arouse vigilance for unexpected thrombosis after ovarian hyperstimulation and to serve as a clinical reference of this condition. This paper reports the case of a woman with double pulmonary embolism and left common iliac vein thrombosis after IVF-ET and the successful management of this condition. The woman had primary infertility, and underwent IVF-ET with 14 ooeytes recovered and two embryos transferred. The patient suffered breathing difficulty 17 days after the ET, and was hospitalized 6 days later as her condition had exacerbated. Computed tomographic （CT） angiography of pulmonary arteries showed double pulmonary embolism, left common iliae vein thrombosis, abnormal density shadow in uterine appendages, and ascites. A healthy baby boy and girl were safely delivered by Caesarean section after successful treatment. Thrombosis after IVF-ET is an uncommon but life-threatening complication and concurrent pulmonary embolism is even rarer. It is suggested that careful thrombosis risk assessment be taken before therapy and particular attention be paid to patients with special body constitutions to develop thrombosis. Whenever patients experience breathing difficulty after IVF-ET, it is strongly advised to examine the possibility of pulmonary embolism. The main treatments for thrombosis are anticoagulant therapy by low-molecular-weight heparin and thrombolysis by urokinase.展开更多
文摘目的:比较能谱CT碘基物质图与CTPA对检出肺段以下动脉栓子的应用对比。方法:利用能谱CT物质分离技术对32例肺段以下肺动脉栓塞患者进行能谱C T血管造影检查。通过容积数据在后处理工作站上利用碘水分离技术重建出碘基物质图及CTPA图(包括MPR、MIP及VRT),根据碘基物质图上碘含量减低区对应查找肺栓塞栓子数量,与C T P A图上所发现的栓子数量进行对比,利用统计学软件进行统计分析两者之间的差异。结果:32例肺栓塞患者中碘基图上按段及亚段以下血管分布区共发现72个碘含量减低区(直接发现栓子共65个,只发现碘含量减低区的间接栓子7个);而在CTPA图上直接显示栓子45个;通过碘基图和CTPA联合观察共发现栓子75个。利用配对T检验,发现碘基图与CTPA图两组之间以及两组联合应用与CTPA之间的比较有统计学意义(P<0.05);而碘基图和碘基图与CTPA图联合应用两者之间无统计学差异(P>0.05)。结论:能谱C T碘基物质图对肺段以下肺动脉栓塞患者的栓子检出率优于CTPA,两者联合应用可明显提高肺段以下肺动脉栓塞的栓子检出率。
文摘Objective. To investigate the high risk factors, clinical features, diagnosis and treatment of pulmonary embolism (PE) during pregnancy and the postpartum period.Methods. Two cases of PE during pregnancy and postpartum period were reported retrospectively.Results. The first case was a pregnant woman with congenital heart disease at 39-week gestation. She underwent a successful cesarean section (CS) because of heart disease, but she manifested tachycardia, tachypnea, cyanosis, and dyspnea suddenly on the 10th day after CS and died soon after the onset of these symptoms. The diagnosis of PE was highly suspected clinically. The second case was a twin-pregnancy woman at 35-week gestation. Because of severe perinatal myocardiopathy, cesarean section was performed. Unfortunately, the patient died abruptly on the operation table. The diagnosis of PE was confirmed by autopsy.Conclusions. The maternal mortality of PE during pregnancy and postpartum period is quite high. Whenever there is any doubt, objective examinations for PE should be started early in order to strive for the chances of the anticoagulant therapy.
文摘This article discusses the mechanism, diagnosis, and treatment of a case of double pulmonary embolism and left common iliac vein thrombosis following in vitro fertilization （IVF） and embryo transfer （ET） to arouse vigilance for unexpected thrombosis after ovarian hyperstimulation and to serve as a clinical reference of this condition. This paper reports the case of a woman with double pulmonary embolism and left common iliac vein thrombosis after IVF-ET and the successful management of this condition. The woman had primary infertility, and underwent IVF-ET with 14 ooeytes recovered and two embryos transferred. The patient suffered breathing difficulty 17 days after the ET, and was hospitalized 6 days later as her condition had exacerbated. Computed tomographic （CT） angiography of pulmonary arteries showed double pulmonary embolism, left common iliae vein thrombosis, abnormal density shadow in uterine appendages, and ascites. A healthy baby boy and girl were safely delivered by Caesarean section after successful treatment. Thrombosis after IVF-ET is an uncommon but life-threatening complication and concurrent pulmonary embolism is even rarer. It is suggested that careful thrombosis risk assessment be taken before therapy and particular attention be paid to patients with special body constitutions to develop thrombosis. Whenever patients experience breathing difficulty after IVF-ET, it is strongly advised to examine the possibility of pulmonary embolism. The main treatments for thrombosis are anticoagulant therapy by low-molecular-weight heparin and thrombolysis by urokinase.
