CT双能量成像评价急性肺栓塞严重程度及右心功能

发布时间：2018-07-16 17:04

【摘要】：目的:探讨CT双能量肺动脉成像(CTPA)和肺灌注成像(DEPI)在评价肺栓塞(PE)严重程度及其所致右心功能不全中的价值。方法:对31例临床拟诊PE患者行CT双能量扫描,采用dual-energy软件获得CTPA、DEPI图像,记录肺动脉内栓子的位置、数目、栓塞类型及肺内灌注异常的程度、位置、数目,并计算肺栓塞指数和灌注缺损率。利用CTPA获得右心功能相关指标。分析Qanadli栓塞指数、灌注缺损率、右心室与左心室的最大横径比(RVd/LVd)及最大面积比(RVa/LVa)之间的相关性以及肺栓塞组和非栓塞组右心功能指标间的差异性。结果:31例患者中20例显示肺栓塞,8例无肺栓塞,2例因肺叶不张、1例因左侧胸腔大量积液而剔除该组研究。Qanadli栓塞指数与肺灌注缺损率具有正相关性(r=0.826,P0.01)。Qanadli栓塞指数、灌注缺损率与RVd/LVd间具有较好的正相关性(r分别为0.610、0.600,P均为0.01);Qanadli栓塞指数、灌注缺损率与RVa/LVa间亦具有较好的正相关性(r分别为0.684、0.655,P均0.01)。栓塞组的RVd/LVd、RVa/LVa较非栓塞组增大(P0.05)。结论:CTPA和DEPI在一定程度上能提示肺栓塞的严重程度及右心功能的受损程度。
[Abstract]:Objective: to evaluate the value of CT dual energy pulmonary angiography (CTPA) and pulmonary perfusion imaging (DEPI) in evaluating the severity of pulmonary embolism (PE) and right ventricular insufficiency. Methods: Ct dual energy scanning was performed in 31 patients with clinically suspected PE. CTPA-DEPI images were obtained by dual-energy software. The location, number, type of embolism, degree, location and number of pulmonary perfusion abnormalities were recorded. Pulmonary embolism index and perfusion defect rate were calculated. The relevant indexes of right ventricular function were obtained by CTPA. The correlation of Qanadli embolization index, perfusion defect rate, right ventricular to left ventricular maximum transverse diameter ratio (RVD / LVd) and maximum area ratio (RVaR / LVa) and the difference of right ventricular function between pulmonary embolism group and non-embolism group were analyzed. Results among 31 patients, 20 cases showed pulmonary embolism, 8 cases without pulmonary embolism, 2 cases without pulmonary embolism, 1 case with left pleural effusion and 1 case with massive pleural effusion. Qanadli embolism index was positively correlated with pulmonary perfusion defect rate (rr 0.826 P 0.01) .Qanadli embolism index. There was a good positive correlation between the perfusion defect rate and Rvd / LVd (r = 0.610 ~ 0.600, P = 0.01), and there was also a good positive correlation between the perfusion defect rate and RVa- / LVa (r = 0.684 ~ 0.655g, P = 0.01). The RVD / LVdN RVaR / LVa in the embolization group was higher than that in the non-embolization group (P 0.05). Conclusion to some extent, the degree of pulmonary embolism and the damage of right heart function can be indicated by the ratio of% CTPA and DEPI.
【作者单位】：徐州医学院附属医院影像科;
【分类号】：R563.5

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