早期左心舒张功能不全的胸部HRCT诊断价值  

Chest HRCT Diagnostic Methods of Early Left Heart Diastolic Dysfunction

作　　者：胡宴宾 符水 陈仲平 张文清 康占龙 黄向明 李明生 丁云贵 

机构地区：[1]深圳观澜人民医院放射科,深圳518110

出　　处：《影像技术》2013年第5期3-6,共4页Image Technology

摘　　要：目的:探讨早期左心舒张功能不全的胸部高辨率CT(HRCT)诊断价值。方法:分析我院近3年来46例临床、心脏彩超诊断为早期左心舒张功能不全病例的HRCT肺小叶的主要征象(小叶间隔增宽、小叶中心A增大、小叶密度增高、胸膜下弧线影)出现频率、分级级别,各主要征象与肺静脉、肺动脉、左心房、左心室等增大程度的相关性,追踪左心舒张功能不全的转归与肺小叶主要征象相关性。结果:①46例患者HRCT肺小叶的小叶间隔增宽为:Ⅰ级1例(2.2%)、Ⅱ级19例(41.3%)、Ⅲ级21例(45.7%)、Ⅳ级5例(10.9%)。小叶间隔增宽、小叶密度增高、小叶中心A增大、胸膜下弧线影等彼此间具有显著相关性。②在早期左心舒张功能不全诊断上,肺小叶主要征象与左心房、左心室、右上肺V干、右下肺V干、肺动脉等直径大小无相关性。③3-18个月病例追踪显示肺小叶主要征象与左心舒张功能不全的转归呈正相关性。结论:胸部HRCT肺小叶的主要征象提示早期左心舒张功能不全具有重要的价值。Objective： Discuss chest HRCT diagnostic methods of early left heart diastolic dysfunction. Methods： Analyze main signs, frequency, levels of 46 cases operated within 3 years in echocardiography diagnosis of early left ventricular diastolic dysfunction in cases of HRCT pulmonary lobule （Interlobular septal broadening, centrilobular A increases, lobular density increase, subpleural lines）, relevancy of main signs and the degree of increase of Pulmonary vein, pulmonary artery, the left atrium, the left ventricle. Follow up relevancy of final outcome of left ventricular diastolic dysfunction and main signs of Lung lobules. Results： （~） HRCT Pulmonary septal broadening of 46 patients： one case in grade I （2.2%）, 19 cases in grade II （41.3%）, 21 cases in grade III （45.7%）, 5 cases in grade IV （10.9%）. An obvious relevancy of Septal leaflet width, density, centrilobular A increases, subpleural lines. （~） In diagnose of early left ventricular diastolic dysfunction, there was no correlation of main signs of pulmonary lobule and diameter sizes of the left atrium and left ventricle, the fight upper lung V stem, V stem of the fight lower lung, and pulmonary artery. （~） Cases track of 3-18 months reveals that there was a correlation between main signs of pulmonary lobule and final outcome of left heart diastolic dysfunction. Conclusion： Main signs of chest HRCT pulmonary lobule have an important value of reminding early left ventricular diastolic dysfunction.

关 键 词：左心舒张功能不全 胸部HRCT 肺小叶 

分 类 号：R816.2[医药卫生—放射医学]