CT静脉造影下肢深静脉血栓密度与急性肺栓塞的相关性研究  

Correlation between lower-extremity deep venous thrombosis density and acute pulmonary embolism under CT venography

作　　者：陆威 徐昱 邓广均 张春浩 LU Wei;XU Yu;DENG Guang-jun;ZHANG Chun-hao(Imaging Department,Nantong Tongzhou People’s Hospital,Nantong,Jiangsu 226399,China)

机构地区：[1]南通市通州区人民医院,江苏南通226399

出　　处：《临床肺科杂志》2022年第9期1362-1366,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨CT静脉造影图像上下肢深静脉血栓(deep venous thrombosis,DVT)密度与DVT患者发生急性肺栓塞(acute pulmonary embolism,APE)风险之间的关系。方法本研究中,患者被分为两组:DVT合并PE组(A组)和单纯DVT组(B组)。记录两组患者wells评分、血栓密度比(DVT患者血栓内CT值/周围静脉CT值),统计分析ROC曲线,评估血栓密度比和Wells是评分对PE风险的预测效能。结果合计纳入86名患者,男性51例,女性35;A组54例,B组32例;平均年龄为60±17岁。A组平均血栓密度比明显高于B组(分别为53.6%±12.4和42.8%±11.9;P<0.001)。在多变量分析中,Wells得分>4(优势比,12.0;95%可信区间:3.0,47;P<0.001)和高血栓密度比(优势比,1.1;95%可信区间:1.0,1.2;P=0.001)是PE的独立预测因子。高血栓密度比的预测效能(ROC曲线下面积0.74;95%可信区间:0.63,0.85;P<0.001)比Wells评分(ROC曲线下面积0.70;95%可信区间:0.59,0.81;P=0.002)更高。结论下肢深静脉血栓形成(DVT)患者CT静脉造影的深静脉血栓密度比与急性肺栓塞相关。Objective To investigate the relationship between the density of lower extremity deep venous thrombosis(DVT)on CT venography images and the risk of acute pulmonary embolism(APE)in DVT patients.Methods In this study,patients were divided into two groups:DVT combined with PE group(Group A)and DVT alone group(Group B).Wells score and thrombus density ratio(DVT thrombus Hounsfield units/surrounding vein Hounsfield units)were recorded in the two groups,and the receiver operating characteristic curve(ROC)was statistically analyzed.was statistically analyzed to evaluate the predictive efficacy of thrombus density ratio and Wells score on the risk of APE.Results A total of 86 patients were included,including 51 males and 35 females.There were 54 cases in group A and 32 cases in group B;The average age was 60±17 years old.The average thrombus density ratio in group A was significantly higher than that in group B(53.6%±12.4 and 42.8%±11.9 respectively;P<0.001).In multivariate analysis,Wells scored>4(odds ratio,12.0;95%confidence interval:3.0,47;P<0.001)and high thrombus density ratio(odds ratio,1.1;95%confidence interval:1.0,1.2;P=0.001)were independent predictors of PE.The predictive power of a high thrombus density ratio(area under the ROC,0.74;95%CI:0.63,0.85;P<0.001)was higher than that of the Wells score(area under the ROC,0.70;95%CI:0.59,0.81;P=0.002).Conclusion The density of lower extremity DVT on CT venography images is associated with APE in DVT patients.

关 键 词：血栓密度 急性肺栓塞 下肢深静脉血栓 

分 类 号：R543.6[医药卫生—心血管疾病] R563.9[医药卫生—内科学]