CTPA间接征象在急性肺栓塞中的诊断价值

发布时间：2018-10-04 22:37

【摘要】：目的分析CTPA间接征象在急性肺栓塞中的诊断价值及其提示意义。方法回顾性搜集1012例临床拟诊肺栓塞患者的CTPA图像,以CTPA作为肺栓塞的确诊依据,对急性肺栓塞和非肺栓塞患者中各种CTPA间接征象进行卡方检验,计算各种间接征象在诊断急性肺栓塞中的敏感性、特异性、阳性预测值和阴性预测值。结果间接征象在急性肺栓塞和非肺栓塞患者中出现率具有显著性差异的包括:肺实变影、线性肺不张、心包积液、肺门部血管扩张、肺野内血管细小和下腔静脉返流。其中胸膜下楔形影的敏感性为16.8%、特异性为95.3%、阳性预测值为58%、阴性预测值为75.1%;胸膜下线性肺不张分别为17.9%、89.6%、39.7%、74.2%;肺门部血管扩张分别为3.2%、3.2%、60%、72.9%;肺野纹理血管细小分别为6.1%、100%、100%、73.7%;下腔静脉返流分别为21.1%、84.4%、34.1%、73.8%。结论肺实变影、肺不张、胸腔积液是肺栓塞最常见的间接征象。胸膜下楔形实变影、线状肺不张影、肺门部血管扩张、肺野内血管稀少对疑似肺栓塞患者具有提示诊断意义。
[Abstract]:Objective to analyze the diagnostic value of indirect signs of CTPA in acute pulmonary embolism. Methods the CTPA images of 1012 patients with clinically suspected pulmonary embolism were collected retrospectively. The indirect signs of CTPA in acute pulmonary embolism and non-pulmonary embolism were examined by chi-square test with CTPA as the basis for the diagnosis of pulmonary embolism. The sensitivity, specificity, positive predictive value and negative predictive value of indirect signs in the diagnosis of acute pulmonary embolism were calculated. Results there were significant differences in indirect signs between acute pulmonary embolism and non-pulmonary embolism, including pulmonary consolidation, linear atelectasis, pericardial effusion, portal vasodilation, small intrapulmonary vessels and inferior vena cava reflux. The sensitivity of subpleural cuneiform shadow was 16.8, the specificity was 95.3, the positive predictive value was 58 and the negative predictive value was 75.1; the subpleural linear atelectasis was 17.989. 6% and 39. 7%, respectively. Venous regurgitation was 21. 1% and 84. 4% and 34. 1% and 73. 8%, respectively. Conclusion Pulmonary consolidation, atelectasis and pleural effusion are the most common indirect signs of pulmonary embolism. Subpleural wedge-shaped consolidation, linear atelectasis, hilar vasodilation and lack of blood vessels in the lung field may be helpful for the diagnosis of suspected pulmonary embolism.
【作者单位】：宁夏医科大学总医院放射科;
【分类号】：R563.5

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