肺栓塞患者伴右心功能不全的CT影像学表现分析  

Analysis of CT Imaging Features of Patients with Pulmonary Embolism Accompanied by Right Ventricular Failure

作　　者：王忠明[1] 苏爱芹[1] 曹琪[1] 华星[1] 陈筛扣[1] 王刚[1] 

机构地区：[1]江苏省泰州市第二人民医院放射科,江苏泰州225500

出　　处：《中国CT和MRI杂志》2017年第1期64-66,82,共4页Chinese Journal of CT and MRI

摘　　要：目的分析肺栓塞伴有右心功能不全患者CT影像学表现。方法将我院自2013年2月-2015年2月经CT肺血管造影(CTPA)证实为肺栓塞的60例患者作为研究对象,同时选取同期接受CTPA检查但未合并肺栓塞的40例患者作为对照组,均接受CT肺动脉造影检查,并于2d内作超声心动图检查,分析肺栓塞伴右心功能不全患者CT诊断价值。结果研究组右心室最大短轴直径为(3.65±0.91)cm、最大横截面积为(18.20±6.12)cm,均明显大于对照组(P<0.05);以超声心动图为标准,CTPA检出右心室扩大敏感度为71.43%,特异度为89.74%;中央型患者最大横截面积大于周围型肺栓塞患者(P<0.05)。结论在肺栓塞伴右心功能不全患者的临床诊断中,采用CTPA检查方式,兼具较高的敏感度与特异性,且可在检出肺栓塞的同时判断患者有无右心扩大及功能不全表现,可为患者的临床治疗方案的确立提供指导。Objective To analyze the CT imaging features of patients with pulmonary embolism accompanied by right ventricular dysfunction. Methods 60 patients with pulmonary embolism confirmed by CT pulmonary angiography（CTPA） admitted into the hospital from February 2013 to February 2015 were selected as the research object. And another 40 patients receiving CTPA examination but not complicated with pulmonary embolism were selected as the control group. Thay all received CT pulmonary angiography and ultrasonic echocardiography with 2d. The the diagnostic value of CT in patients with pulmonary embolism accompanied by right ventricular dysfunction was analyzed. Results The maximum stub axle diameter of right ventricular in the research group was（3.65±0.91） cm and the largest cross-sectional area was（18.20±6.12） cm which were significantly higher than those in the control group（P〈0.05）. Taking ultrasound echocardiography as the standard, the sensitivity of right ventricle expand detected by CTPA was 71.43% and the specificity was 89.74%, the maximum cross sectional area of the central type patients was larger than that of peripheral type patients with pulmonary embolism（P〈0.05）. Conclusion In the clinical diagnosis of patients with pulmonary embolism accompanied by right ventricular dysfunction, to adopt CTPA examination is of both high sensitivity and specificity and can detect pulmonary embolism and judge whether patients have right heart enlargement and dysfunction, which can provide guidance for the clinical establishment of treatment regimen for patients.

关 键 词：肺栓塞 右心功能不全 CT 影像学特点 

分 类 号：R563.5[医药卫生—呼吸系统]