双源CT肺动脉成像对急诊肺动脉栓塞的临床诊断应用研究  

Clinical Diagnostic Application of Dual-Source CT Pulmonary Angiography in Emergency Pulmonary Embolism

作　　者：高江晖 马洪宇 王国庆 于庆康 石少聪 GAO Jianghui;MA Hongyu;WANG Guoqing;YU Qingkang;SHI Shaocong(Radiology Department,Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou Henan 450007,China)

机构地区：[1]郑州市中医院放射科,河南郑州450007

出　　处：《临床研究》2024年第9期121-123,共3页Clinical Research

摘　　要：目的通过对急诊肺动脉栓塞患者进行双源电子计算机断层扫描(CT)肺动脉成像检查,以了解其诊断意义,为后续临床治疗提供参考性依据。方法选择2022年6月至2023年9月郑州市中医院急诊收治的82例疑似肺动脉栓塞患者作为本次研究对象,所有患者均接受双源CT肺动脉成像检查,以肺动脉造影作为金标准,分析患者的诊断效能情况,并对确诊的急诊肺动脉栓塞患者一般情况进行分析。结果双源CT肺动脉成像技术检查的准确度、灵敏度与特异度分别为92.68%、93.33%与85.71%,约登指数为0.790。经双源CT肺动脉成像检查确诊的71例患者中共检查出490个栓子,其中,肺叶、肺段与肺亚段栓塞部位各有139个(28.37%)、273个(55.71%)与78个(15.92%),其中,肺叶部分栓塞中肺灌注降低情况(50.35%)居多,完全栓塞中以肺灌注缺损(25.90%)居多;肺段中以肺灌注降低的部分栓塞(36.63%)为主;肺亚段中以肺灌注缺损的完全缺损(29.49%)为主。结论双源CT肺动脉成像检查技术与肺动脉造影诊断结果无较大差异,对诊断急诊肺动脉栓塞具有一定的准确度、灵敏度与特异度且该诊断方式能够明确急诊肺动脉栓塞的发生部位与灌注情况,具有临床诊断应用价值。Objective To understand the diagnostic significance of dual-source computed tomography(CT)pulmonary angiography in patients with emergency pulmonary embolism and provide a reference for subsequent clinical treatment.Methods A total of 82 patients with suspected pulmonary embolism admitted to the emergency department of Zhengzhou Traditional Chinese Medicine Hospital from June 2022 to September 2023 were selected as the study subjects.All patients underwent dual-source CT pulmonary angiography,with pulmonary angiography as the gold standard.The diagnostic efficacy was analyzed,and the general condition of patients diagnosed with emergency pulmonary embolism was examined.Results The accuracy,sensitivity,and specificity of dual-source CT pulmonary angiography were 92.68%,93.33%,and 85.71%,respectively,with a Youden index of 0.790.Among the 71 patients diagnosed with pulmonary embolism by dual-source CT pulmonary angiography,a total of 490 emboli were detected.There were 139(28.37%)emboli in the pulmonary lobes,273(55.71%)in the pulmonary segments,and 78(15.92%)in the subsegments.Among the partial emboli in the pulmonary lobes,reduced pulmonary perfusion was most common(50.35%),while complete emboli were mostly associated with pulmonary perfusion defects(25.90%).In the pulmonary segments,partial emboli with reduced pulmonary perfusion(36.63%)were predominant.In the subsegments,complete defects with pulmonary perfusion defects(29.49%)were most common.Conclusion The diagnostic results of dualsource CT pulmonary angiography are not significantly different from those of pulmonary angiography.It has certain accuracy,sensitivity,and specificity in diagnosing emergency pulmonary embolism and can clearly identify the location and perfusion status of the embolism,making it valuable for clinical diagnosis.

关 键 词：肺动脉栓塞 肺动脉成像 双源CT 诊断效能 

分 类 号：R543.3[医药卫生—心血管疾病]