肺动脉CTA与D-二聚体对肿瘤患者肺栓塞诊断的一致性研究  

The Consistency Study of Pulmonary Artery CTA and D-dimer in the Diagnosis of Pulmonary Embolism in Tumor Patients

作　　者：张建泉[1] 沈智勇[1] 龚海鹏 张慧[1] 王丽[1] ZHANG Jian-quan;SHEN Zhi-yong;GONG Hai-peng;ZHANG Hui;WANG Li(Department of Imaging,Nantong Tumor Hospital,Nantong 226361,Jiangsu province,China)

机构地区：[1]南通市肿瘤医院影像科,江苏南通226361

出　　处：《中国CT和MRI杂志》2025年第1期72-74,共3页Chinese Journal of CT and MRI

基　　金：南通市226人才基金(YYRC1710)。

摘　　要：目的 分析肺动脉CT angiography(CTA)与D-二聚体在肿瘤患者急性肺动脉栓塞诊断中的一致性。方法 收集南通市肿瘤医院2019-2021年住院的肿瘤患者中,临床怀疑肺栓塞的连续80例患者作为研究对象,所有患者进行D-二聚体检测、肺动脉CTA检查,使用Kappa检验比较两者对急性肺栓塞诊断的一致性。结查92.5%(74/80)的患者两者检查一致,其中两者均阳性(诊断为肺动脉栓塞)62例,两者均阴性(诊断为非肺动脉栓塞)12例。7.5%(6/80)的患者两者检查不一致,其中D-二聚体阳性而肺动脉CTA阴性(两肺动脉及其分支未见明显栓子形成)4例;D-二聚体阴性而肺动脉CTA阳性(肺动脉分支栓子形成)2例。Kappa值为0.75,P<0.01。结论D-二聚体与肺动脉CTA对肺动脉栓塞检查具有较高的一致性。肺动脉CTA在肺栓塞的诊断中具有重要价值。少部分D-二聚体阴性患者,如有相应临床症状,仍需及时肺动脉CTA,以排除肺栓塞可能。Objective To analyze the consistency of pulmonary artery CT angiography(CTA) and D-dimer in the diagnosis of acute pulmonary embolism in tumor patients.Methods A total of 80 consecutive cancer patients admitted to Nantong Tumor Hospital from 2019 to 2021with clinical suspicion of pulmonary em bolism were collected.All patients u nderwe nt D-dimer test and pulmonary artery CTA examination,and Ka ppa test was used to compare the consistency of the two methods in the diagnosis of acute pulmonary embolism.Results 92.5%(74/80) of patients had consistent between the two tests;Among them,both were positive(diagnosed as pulmonary embolism) in 62 cases,and both were negative(diagnosed as non pulmonary embolism) in 12 cases.7.5%(6/80) of patients had inconsistent examinations,with 4 cases disclosing positive D-dimer but negative pulmonary artery CTA(no obvious thrombus formation observed in both pulmonary arteries and their branches);while two cases were negative for D-dimer and positive for pulmonary artery CTA(pulmonary artery branch thrombosis).The Kappa value was 0.75,with P<0.01.Conclusion The results of pulmonary artery CTA and D-dimer are consistent in pulmonary embolism examination.Pulmonary artery CTA has importa nt value in the diagnosis of pulmonary embolism.A few patients with negative D-dimer,if they have correlated clinical symptoms,need to undergo pulmonary artery CTA in time to rule out the possibility of pulmonary embolism.

关 键 词：肺动脉CTA D-二聚体 肺栓塞 肿瘤 

分 类 号：R563.5[医药卫生—呼吸系统]