不同类型急性肺栓塞继发性改变胸部CTPA影像学表现及临床特征对比  

Comparison on Chest CTPA Imaging Manifestations and Clinical Features of Different Types of Secondary Changes of Acute Pulmonary Embolism

作　　者：常亮 吴迪 李伟 田宝建 王瀚宇 CHANG Liang;WU Di;LI Wei;TIAN Bao-jian;WANG Han-yu(Department of Emergency,International Medical Center Hospital,Xi’an 710100,Shaanxi Province,China)

机构地区：[1]西安国际医学中心医院急诊科,陕西西安710100

出　　处：《中国CT和MRI杂志》2023年第1期60-61,69,共3页Chinese Journal of CT and MRI

基　　金：陕西省社会发展攻关项目(2019SF-169)。

摘　　要：目的 对比不同类型急性肺栓塞继发性改变胸部CTPA影像学表现及临床特征。方法 回顾性收集2017年10月至2019年10月本院收治的89例急性肺栓塞患者的临床资料。对比不同类型急性肺栓塞患者临床特征以及CTPA胸壁继发改变差异。结果 周围型急性肺栓塞50例,中央型急性肺栓塞39例。不同类型急性肺栓塞患者在年龄、性别、临床表现、手术/创伤史、其他(肿瘤、慢性肺病、肺部感染)上比较差异无统计学意义(P>0.05);而在危险分层中,中央型急性肺栓塞患者中、高危比例高于周围型急性肺栓塞患者,低危型低于周围型患者,(P<0.05);不同类型急性肺栓塞患者继发性改变胸部CTPA检查影像学表现中肺动脉干增粗、右心增大、马赛克征、肺梗死上比较差存在统计学意义(P<0.05),周围型急性肺栓塞患者肺动脉干增粗、右心增大、马赛克征、肺梗死发生机率均明显低于中央型急性肺栓塞患者(P<0.05);两组患者在心包积液、Westermark征、胸腔积液、肺不张CTPA影像学征象上比较差异无统计学意义(P>0.05)。结论 不同类型急性肺栓塞患者病情严重程度存在差异,中央型患者胸部继发性改变较大,在临床中需要及时确定疾病类型,对患者预后有积极意义。Objective To compare the chest CTPA imaging manifestations and clinical features of different types of secondary changes of acute pulmonary embolism. Method The clinical data of 89 patients with acute pulmonary embolism admitted in our hospital from October 2017 to October 2019 were retrospectively collected. The clinical features of different types of patients with acute pulmonary embolism and the differences in CTPA chest of secondary changes were compared. Results There were 50 cases with peripheral acute pulmonary embolism and 39 cases with central acute pulmonary embolism. There is no significant difference in age, gender, clinical manifestations, history of surgery/trauma, and others(tumor, chronic lung disease, lung infection) among patients with different types of acute pulmonary embolism(P>0.05). For risk stratification, among patients with central type acute pulmonary embolism, the proportion of patients with middle or high risk is higher than that in patients with peripheral acute pulmonary embolism, and the proportion of patients with low-risk type is lower than that in patients with peripheral acute pulmonary embolism(P<0.05). There are statistically significant differences in the in the thickening of the pulmonary artery trunk, the enlargement of the right heart, the mosaic sign, and pulmonary infarction in chest CTPA imaging of secondary changes in patients with different types of acute pulmonary embolism(P<0.05). The incidences of thickened pulmonary artery trunk, enlarged right heart, mosaic sign, and pulmonary infarction in patients with peripheral acute pulmonary embolism were significantly lower than those in patients with central acute pulmonary embolism(P<0.05). There was no significant difference between the two groups in CTPA imaging signs of pericardial effusion, Westermark sign, pleural effusion, and atelectasis(P>0.05). Conclusion The severity of patients with different types of acute pulmonary embolism is different. In patients with central pulmonary embolism, the secondary changes in

关 键 词：不同类型 急性肺栓塞 继发性改变 CTPA 影像学表现 

分 类 号：R563.5[医药卫生—呼吸系统]