CT平扫与CTPA在肺栓塞邻近肺组织血供变化中的诊断价值对比  

Comparison of diagnostic value of CT plain scan and CTPA in blood supply changes in tissue adjacent to pulmonary embolism

作　　者：马玉萍[1] 栾丽[1] MA Yuping;LUAN Li(Department of Medical Imaging,Traditional Chinese Medicine Hospital Affiliated of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院医学影像科,新疆乌鲁木齐830000

出　　处：《中国中西医结合影像学杂志》2024年第6期657-660,665,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：新疆医科大学附属中医医院院级课题(ZYY202005)。

摘　　要：目的:对比分析CT平扫与CT肺动脉血管成像(CTPA)在肺栓塞邻近肺组织血供变化中的诊断价值。方法:回顾性分析120例急性肺栓塞患者,其中主肺动脉栓塞(主肺动脉栓塞组)、左右肺动脉干栓塞(左右肺动脉干栓塞组)、叶间动脉栓塞(叶间动脉栓塞组)各40例。3组均行肺部CT平扫及CTPA。3组CT值与CTPA血流参数行Pearson相关性分析。3组CT值行logistic回归分析。采用ROC曲线分析各组CT值对肺栓塞邻近肺组织血供变化的诊断效能。结果:3组的CT值与肺毛细血管嵌压(PCWP)、肺动脉舒张压(PAPd)、肺动脉收缩压(PAPs)均呈正相关(均P<0.05)。多因素logistic回归分析显示,PCWP、PAPd、PAPs是影响各组CT值的独立危险因素(均P<0.05)。主肺动脉栓塞组平扫CT值诊断肺组织血供变化的敏感度为82.12%、特异度为81.31%、AUC为0.735,左右肺动脉干栓塞组分别为83.10%、82.10%、0.741,叶间动脉栓塞组分别为80.01%、82.00%、0.723。结论:CT平扫可准确反映肺栓塞邻近肺组织血供变化,可作为临床诊断肺栓塞的间接征象。Objective:To compare and analyze the diagnostic value of CT plain scan and CT pulmonary angiography(CTPA)in the changes of blood supply in pulmonary tissue adjacent to pulmonary embolism.Methods:Retrospective analysis was performed on 120 patients with acute pulmonary embolism,including 40 cases of main pulmonary embolism,40 cases of left and right pulmonary trunk embolism and 40 cases of interlobar artery embolism.All patients underwent lung CT plain scan and CTPA.CT values and CTPA parameters of 3 groups were used with Pearson correlation analysis,and CT values of 3 groups were used with logistic regression analysis.ROC curve was used to analyze the diagnostic value of CT values for the blood supply changes in the adjacent lung tissue of pulmonary embolism.Results:In the 3 groups,CT values were significantly positively correlated with pulmonary capillary wedge pressure(PCWP),pulmonary artery diastolic pressure(PAPd)and pulmonary artery systolic pressure(PAPs)(all P<0.05).Multivariate logistic regression analysis showed that PCWP,PAPd and PAPs were independent risk factors affecting CT values in each group(all P<0.05).The sensitivity,specificity and AUC of CT value for the diagnosis of pulmonary tissue blood supply changes in the main pulmonary embolism group were 82.12%,81.31%and 0.735,and those in the left and right pulmonary trunk embolism group were 83.10%,82.10%and 0.741,and those in the interlobular artery embolism group were 80.01%,82.00%and 0.723,respectively.Conclusions:CT plain scan can accurately reflect the changes of blood supply in the adjacent lung tissue,and can be used as a reliable method for diagnosing pulmonary embolism in clinic.

关 键 词：体层摄影术 X线计算机 肺动脉栓塞 肺组织血供 

分 类 号：R563.5[医药卫生—呼吸系统] R816.4[医药卫生—内科学]