CT肺动脉栓塞指数评价急性肺栓塞患者右心功能  

Assessment on right ventricular function of patients with acute pulmonary embolism with CT pulmonary artery obstruction index

作　　者：周新卫[1] 王建国[1] 刘冬[2] 朱力[3] 马钦华[1] 郭佑民[4] 

机构地区：[1]深圳市罗湖区人民医院放射科,广东深圳518001 [2]深圳市儿童医院ICU室,广东深圳518040 [3]宁夏医学院附属医院影像中心,宁夏银川750004 [4]西安交通大学第一医院PET/CT室,陕西西安710061

出　　处：《中国医学影像技术》2011年第1期69-73,共5页Chinese Journal of Medical Imaging Technology

基　　金：罗湖区软科学研究计划项目(2009007)

摘　　要：目的探讨CT肺动脉栓塞指数(PAOI)半定量评价急性肺栓塞(APE)右心功能的价值。方法 回顾性分析经CT肺血管成像(CTPA)确诊的、无严重基础心肺疾病的APE患者117例,依据肺动脉内栓子阻塞的部位及程度计算PAOI。根据PAOI<30%、30%～50%和>50%将APE患者分为轻、中和重度三组,分析各组的右心功能参数的差异。结果 入选患者中,轻度组65例,中度组32例,重度组20例。轻度与中度组比较,差异有统计学意义的指标有RVd、LVd、RVd/LVd、RVs、LVs、RVs/LVs、MPA、LPA、IVSD、IVCR;轻度组与重度组比较,差异有统计学意义的指标有RVd、LVd、RVd/LVd、RVs、LVs、RVs/LVs、SVC、MPA、RPA、LPA、IVSD、IVCR、AZR;中度组与重度组比较,差异有统计学意义的指标有LVd、RVd/LVd、RVs/LVs。结论 APE患者的PAOI可以反映右心功能情况,并有助于及时确认APE的病情程度。Objective To semi-quantitatively evaluate the right ventricular function in patients with acute pulmonary embolism（APE） with CT pulmonary artery obstruction index（PAOI）.Methods Totally 117 patients with APE diagnosed with spiral computed tomography were retrospectively analyzed and selected as being non-severe of underlying cardiopulmonary disease.PAOI was estimated on the basis of the degree of obstruction and location of the thrombus on CT imaging according to the method described by Mastora etc.The patients were divided into mild,moderate or severe categories according to PAOI 30%,30%-50%,50%.The differences of cardiovascular parameters among the three groups were calculated.Results There were 65,32 and 20 patients in mild,moderate and severe groups,respectively.Comparison of cardiovascular parameters between mild and moderate groups showed significant differences in right ventricle diameter（RV_d） and right ventricle square（RV_s）,left ventricle diameter（LV_d） and left ventricle square（LV_s）,right ventricle/left ventricle diameter ratio（RV_d/LV_d） and right ventricle/left ventricle square（RV_s/LV_s）,main pulmonary artery（MPA）,left pulmonary artery（LPA）,interventricular septum deviation（IVSD）,as well as in reflux of the inferior vena cava（IVCR）.Comparison of mild and severe groups showed significant differences in RV_d,LV_d,RV_d/LV_d,RV_s,LV_s,RV_s/LV_s,SVC,MPA,right pulmonary artery（RPA）,LPA,IVSD,IVCR and reflux of the azygos vein（AZR）.Comparison of moderate and severe groups showed significant differences in LV_d,RV_d/LV_d and RV_s/LV_s.Conclusion CTPA obstruction index can reflect the right heart function of acute pulmonary embolism,being prompt to confirm the extent of APE in the first time.

关 键 词：肺栓塞 血管造影术 肺动脉栓塞指数 

分 类 号：R563.5[医药卫生—呼吸系统] R814.42[医药卫生—内科学]