急性肺动脉栓塞的CT平扫征象分析  

The analysis of non- contrast CT signs in acute pulmonary embolism

作　　者：季云海[1] 王绍波[1] 何宏[1] 佘波[1] 江勇[2] 

机构地区：[1]云南省第一人民医院PET/CT中心,云南昆明650032 [2]云南省第一人民医院核医学科,云南昆明650032

出　　处：《云南医药》2016年第2期162-166,共5页Medicine and Pharmacy of Yunnan

摘　　要：目的评估CT平扫征象在急性肺动脉栓塞(PE)中的诊断价值。方法将我院行双源64层螺旋CT检查的116例疑诊PE患者进行回顾性研究,其中19例患者既往患有慢性肺部疾患,97例无慢性肺部疾患病史。对以下CT平扫征象进行分析:马赛克征、肺实变(胸膜下楔形实变,其他类型实变)、Westermark征、胸腔积液(少量,中到大量)、肺动脉高压。结果入组的所有116例患者中最终诊断PE 76例、非PE 40例,胸膜下楔形实变影、Westermark征及少量胸腔积液有助于提示PE诊断,敏感性和特异性分别为40.8%和90.0%、25.0%和92.5%及40.8%和77.5%(P均<0.05)。在97例无慢性肺部疾患病史的患者中最终诊断PE 64例、非PE 33例,马赛克征、胸膜下楔形实变影、Westermark征、少量胸腔积液、肺动脉高压有助于提示PE诊断,敏感性及特异性分别为20.3%和97.0%、39.1%和87.9%、25.0%和97.0%、42.2%和81.8%及34.4%和84.8%(P均<0.05)。结论尽管CT平扫征象诊断敏感性不高,但相对高的特异性有助于提示PE的诊断,特别是在无慢性肺部疾患病史的患者中。Objective To evaluate non- contrast CT signs in diagnosis of acute pulmonary embolism（PE）. Methods A total of 116 patients with suspected PE（19 patients with history of chronic lung diseases, 97 cases with no history of chronic lung diseases） who underwent dual source 64 slices CT were retrospectively recruited. The following CT signs were analyzed： Mosaic sign, pulmonary consolidation（subpleural wedge consolidation or other consolidation）,Westermark sign, pulmonary hypertension, pleural effusion（a small amount or a middle to large amount）. Results Of the total of 116 patients, PE was confirmed in 76 cases and non- PE in 40 cases. Subpleural wedge consolidation,Westermark sign and a small amount of pleural effusion were helpful to predict PE, and the respective sensitivity and specificity were 40.8% and 90.0%, 25.0% and 92.5% and 40.8% and 77.5%（all P〈0.05）. In 97 patients with no history of chronic lung diseases, PE was confirmed in 64 cases and non- PE in 33 cases. Mosaic sign, subpleural wedge consolidation, Westermark sign, a small amount of pleural effusion, and pulmonary hypertension were helpful to PE,and the respective sensitivity and specificity were 20.3% and 97.0%,39.1% and 87.9%,25.0% and 97.0%,42.2% and81.8%,and 34.4% and 84.8%（all P〈0.05）. Conclusion In spite of the low sensitivity,the relatively high specificity of certain non- contrast CT signs will help to predict PE,especially in patients with no history of chronic lung diseases.

关 键 词：肺动脉栓塞 计算机体层摄影 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学]