CT肺动脉造影衍生左心房参数与急性肺栓塞血栓负荷相关  

Correlation of Computed Tomography Pulmonary Angiography⁃derived Left Atrial Parameters with Thrombus Load in Acute Pulmonary Embolism

作　　者：叶婉霜 王贵良[1] 刘鹏[1] 孙文杰[1] 王李乐 谢安[1] 曾禹莉[1] YE Wanshuang;WANG Guiliang;LIU Peng;SUN Wenjie;WANG Lile;XIE An;ZENG Yuli(Department of Radiology,Hunan Provincial People’s Hospital(The First Affiliated Hospital of Hunan Normal University),Hunan 410000,China;Department of Respiratory Medicine,Hunan Provincial People’s Hospital(The First Affiliated Hospital of Hunan Normal University),Hunan 410000,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)放射科,湖南410000 [2]湖南省人民医院(湖南师范大学附属第一医院)呼吸科,湖南410000

出　　处：《影像科学与光化学》2025年第2期39-46,共8页Imaging Science and Photochemistry

基　　金：湖南省教育厅科研重点项目(20A330)。

摘　　要：目的:探讨CT肺动脉造影(CTPA)衍生的左心房(LA)参数在评估急性肺栓塞(APE)严重程度中的应用价值,并分析其与APE血栓负荷的相关性。方法:回顾性分析399例患者的临床资料和CTPA资料,将无APE患者设为A组(n=198),APE患者根据PAOI分为B1组(PAOI<40%,n=97)和B2组(PAOI≥40%,n=104)。对比3组间LA测量参数和对比剂填充评价(主观评分和CT值),并采用Spearman相关性分析探讨这些参数与PAOI的关系。结果:3组LA的左右径(LR)、前后径(AP)、LR×AP及LA中央区CT值的比较显示:B2组<B1组<A组,且与PAOI呈负相关;3组LA对比剂填充评分(2分和3分)的比较显示:B2组>B1组>A组,与PAOI呈正相关;3组主肺动脉与LA中央区CT值差值的比较显示:B2组>B1组、A组,但与PAOI无相关性。CTPA衍生的LA参数与APE血栓负荷相关,可作为早期病情评估的附加参数。结论:CTPA衍生的LA参数与APE的血栓负荷密切相关,对于评估APE的严重程度具有潜在的临床价值,有助于指导治疗决策和预测患者预后。Objective:To explore the application value of left atrium(LA)parameters derived from CT pulmonary angiography(CTPA)in evaluating the severity of acute pulmonary embolism(APE)and to analyze the correlation between the parameters with thrombus load of APE.Methods:The clinical and CTPA data of 399 patients were collected retrospectively.Patients without APE were designated as group A(n=198).Patients with APE were classified into group B1(PAOI<40%,n=97)and group B2(PAOI≥40%,n=104)based on PAOI.LA measurement parameters and contrast agent filling evaluation(subjective score and CT value)were compared among the three groups.Spearman correlation analysis explored the correlations between these parameters and PAOI.Results:Comparison of LA left⁃to⁃right diameter(LR),anteroposterior diameter(AP),LR×AP,and CT values in the central area of LA among the three groups showed that group B2<group B1<group A,with a negative correlation with PAOI.Comparison of LA contrast agent filling scores(2⁃point and 3⁃point):group B2>group B1>group A,indicating a positive correlation with PAOI.Comparison of the CT difference between the main pulmonary artery and the central area of the LA:group B2>group B1,group A,there was no correlation with PAOI.The LA parameters derived from CTPA were correlated with the thrombus load,which can be used as additional parameters for early disease assessment.Conclusion:CTPA⁃derived LA parameters are closely associated with the thrombus load of APE and have potential clinical value for assessing the severity of APE,helping to guide treatment decisions and predict the prognosis of patients.

关 键 词：CT肺动脉造影 急性肺栓塞 左心房 肺动脉阻塞指数 右心功能不全 

分 类 号：R563.5[医药卫生—呼吸系统] R816.41[医药卫生—内科学]